Which lesion type is commonly targeted with cutting balloons due to its short length suitability?

• A. Lesions less than 15 mm in length
• B. Diffuse long lesions
• C. Occlusions longer than 50 mm
• D. Vessels larger than 5 mm in diameter

Answer: (A)

Cutting balloons are designed to modify plaque by making controlled incisions as the balloon expands. This scoring helps open the vessel in a focused way with less aggressive stretching, which is especially advantageous for short, focal lesions. When a lesion is short—around 15 mm or less—the incisions can adequately weaken and shape the plaque in that limited segment, allowing effective luminal gain while minimizing the risk of tearing the vessel wall or causing dissection. For longer, diffuse segments, the same approach becomes less practical: multiple incisions would be needed across a prolonged area, increasing complexity, time, and the chance of complications, and the benefit tends to diminish. Vessel size matters less than lesion length in this context, since cutting balloons target length-specific plaque modification rather than simply dilating a larger diameter.