An algorithmic approach to balloon undilatable coronary lesions

Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, Salman Allana, Mohaned Egred, Hani Jneid, Kambis Mashayekhi, Carlo Di Mario, Oleg Krestyaninov, Dmitrii Khelimski, Anastasios Milkas, Yader Sandoval, M. Nicholas Burke, Emmanouil S. Brilakis

Research output: Contribution to journalReview articlepeer-review


Balloon undilatable lesions are lesions that have been successfully crossed by both a guidewire and a balloon but cannot be expanded despite multiple high-pressure balloon inflations. Balloon undilatable lesions can be de novo or in-stent. We describe a systematic, algorithmic approach to treat both de novo and in-stent balloon undilatable lesions using various techniques, such as high-pressure balloon inflation, plaque modification balloons, intravascular lithotripsy, very high-pressure balloon inflation, coronary atherectomy, laser coronary angioplasty, and extraplaque lesion crossing. Knowledge of the various techniques can increase the efficiency, success and safety of the procedure.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
StateAccepted/In press - 2022


  • ATHR - atherectomy
  • BALC - balloon
  • complex PCI
  • cutting
  • LASR - laser
  • PCIC - percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'An algorithmic approach to balloon undilatable coronary lesions'. Together they form a unique fingerprint.

Cite this