Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

Calcified lesions are best managed using which device?

1. Standard balloon catheter

2. Cutting/scoring balloon

3. Stent delivery system

4. IVUS catheter

The correct answer is: Cutting/scoring balloon

Calcified lesions in the cardiovascular system present particular challenges during intervention due to their rigidity and resistance to conventional dilatation techniques. The cutting or scoring balloon catheter is specifically designed to address these challenges. This device features small blades or grooves along its surface, which can create intimal tears in the calcified plaque when inflated, allowing for more effective vessel dilation. By using a cutting/scoring balloon, the interventional cardiologist can prepare the lesion more effectively, making it easier for subsequent interventions, like stenting. This technique not only aids in achieving a greater luminal gain but also reduces the risk of complications compared to using a standard balloon catheter, which may not adequately fracture the calcified tissue. In contrast, while a standard balloon catheter can inflate the vessel, it may not provide the necessary force to break through dense calcification. A stent delivery system is essential for providing structural support after lesion modification, but it does not address the lesion itself. An intravascular ultrasound (IVUS) catheter can assist in imaging and guiding procedures, but it does not play a direct role in the physical management of calcified lesions. Therefore, the use of a cutting/scoring balloon is the most effective strategy for managing calcified lesions in a clinical setting