SRT By Treatment Area
HOW IT WORKS
Serration Remodeling Therapy works across the full anatomy of peripheral vascular disease. Explore how the Serranator and Serranator SL-PRO address each territory, from aortoiliac inflow to pedal revascularization.
No two patients present the same way. A long-segment SFA occlusion, a calcified popliteal stenosis, a CLTI patient with tibial and pedal disease: each territory has its own technical demands, vessel sizing, and clinical stakes.
The Serranator family is built to address the full spectrum. Use the anatomy navigator below to explore how SRT performs in the territory you're treating today.
Select a treatment area to explore →
AV Fistula
Protecting the lifeline, preserving dialysis access with less trauma and more durable results.
Overview: Arteriovenous fistulas are the preferred form of hemodialysis access, but stenosis is a near-universal complication, with most fistulas requiring intervention within the first year. Conventional balloon angioplasty in fistulas is associated with high rates of elastic recoil and restenosis, creating a cycle of repeated interventions that compromise access longevity and patient quality of life.
SRT's point-force mechanism offers a meaningful advantage in this territory. By creating a controlled serration line rather than circumferential stretch, the Serranator achieves consistent lumen gain with less recoil and reduced vessel trauma. The result is more durable patency between interventions, protecting the access that dialysis patients depend on.
| Typical Vessel Diameter | Varies widely; typically 4.0–7.0 mm at stenosis |
| Recommended Serranator Sizes | 4.0-8.0 mm diameters; 40 mm lengths |
| Guidewire | 0.014" / 0.018" |
| Sheath | 6F-7F dependant of diameter |
Recommended Product: Serranator
5.0–7.0 mm diameter range addresses typical fistula stenosis anatomy.
Device Specifications for this Area:
Iliac Artery
Restoring inflow, the foundation of successful peripheral revascularization.
Overview: The iliac arteries carry blood from the aorta to the legs and represent the critical inflow segment of the lower extremity circulation. Stenotic or occlusive iliac disease is common in PAD patients and, when untreated, limits the success of any distal intervention. Lesions in this territory are often large-diameter, heavily calcified, and resistant to conventional balloon angioplasty.
Serration Remodeling Therapy addresses the particular challenge of iliac disease: high-pressure requirements with conventional balloons, unpredictable recoil in calcified segments, and the risk of perforation in a vessel carries significant consequences. The Serranator delivers consistent lumen gain at lower inflation pressures, reducing procedural risk while improving the inflow foundation for downstream treatment.
| Typical Vessel Diameter | 6.0–10.0 mm (common iliac), 4.0–7.0 mm (external iliac) |
| Recommended Serranator Sizes | 6.0 mm-8.0 mm diameter, 40 mm length |
| Guidewire | 0.018" |
| Sheath | 6F-7F dependant of diameter |
Recommended Product: Serranator
Available in diameters up to 8.0 mm to address common iliac vessel sizing.
Device Specifications for this Area:
Common Femoral Artery (CFA)
A challenging territory where surgical and endovascular approaches converge.
Overview: The common femoral artery sits at the transition between the inflow and outflow systems, making it one of the most technically demanding territories in peripheral intervention. CFA disease has historically been managed surgically due to concerns about vessel trauma, endovascular access site complications, and the complex bifurcation anatomy.
SRT's low-pressure, controlled serration mechanism is particularly well-suited to the CFA: it achieves consistent lumen gain without the aggressive overinflation that risks dissection in a vessel where surgical bailout is the alternative. As endovascular management of CFA disease continues to evolve, the Serranator provides a predictable, less-traumatic option for the right patient.
| Typical Vessel Diameter | 6.0–8.0 mm |
| Recommended Serranator Sizes | 6.0 mm, 7.0 mm, 8.0 mm diameters |
| Guidewire | 0.018" |
| Sheath | 6F-7F dependant of diameter |
Recommended Product: Serranator
4.0–8.0 mm diameter range addresses typical CFA sizing.
Device Specifications for this Area:
Superficial Femoral Artery (SFA)
The most commonly treated territory in PAD.
Overview: The SFA is the workhorse of peripheral intervention: the longest peripheral artery, subject to unique biomechanical forces, and the most common site of atherosclerotic disease in the lower extremity. SFA lesions vary widely in length, morphology, and calcification burden, from short focal stenoses to long, diffuse disease with heavy calcification.
This variability is precisely why SRT delivers such consistent results in the SFA. Where plain balloon angioplasty struggles most, in calcified, fibrotic, and long lesions, the Serranator's point-force mechanism continues to produce predictable lumen gain. PRELUDE demonstrated >97.7% freedom from clinically driven target lesion revascularization at 6 months, establishing SRT as a first-line option in this territory.
| Typical Vessel Diameter | 4.0–6.0 mm |
| Recommended Serranator Sizes | 4.0-6.0 mm diameter; 40–120 mm length |
| Guidewire | 0.018" |
| Sheath | 6F |
Recommended Product: Serranator
The 120 mm balloon length addresses long-segment SFA disease.
Device Specifications for this Area:
Popliteal Artery
Dynamic anatomy requiring controlled vessel preparation.
Overview: The popliteal artery is subject to unique biomechanical forces, repeated flexion, extension, and torsion with every step. This makes it one of the most challenging territories for durable results: stents placed in the popliteal have well-documented fracture and thrombosis rates, and conventional balloon angioplasty frequently results in significant recoil in a vessel that sees constant mechanical stress.
SRT's stent-avoidance profile is especially valuable in the popliteal. By delivering effective lumen gain at low pressure with minimal recoil and dissection, the Serranator reduces the need for bailout stenting, preserving the popliteal's natural biomechanical compliance and avoiding the long-term consequences of a stent in a flexion zone.
| Typical Vessel Diameter | 3.5–5.0 mm |
| Recommended Serranator Sizes | 3.5-5.0 mm diameter; 40–120 mm legth |
| Guidewire | 0.014" / 0.018" |
| Sheath | 6F |
Recommended Product: Serranator
3.5–5.0 mm diameter range addresses typical popliteal sizing.
Device Specifications for this Area:
Tibial Arteries
Precise intervention where vessel caliber and disease burden more than conventional balloons can offer.
Overview: The tibial vessels, anterior tibial, posterior tibial, and peroneal arteries, are the critical outflow channels for the lower leg. Disease in this territory is common in diabetic patients and those with advanced PAD, often presenting as diffuse, multi-vessel involvement with significant calcification.
Tibial intervention requires a precise, low-trauma approach: small vessel diameters leave little margin for dissection, and recoil in this territory directly compromises tissue perfusion. SRT's low-pressure mechanism achieves effective lumen gain without the overinflation that risks vessel injury in these small, fragile vessels. The Serranator's BTK performance is backed by PRELUDE-BTK, which demonstrated a 1.9% bailout stent rate, a benchmark result in a territory historically prone to bail-out stenting.
| Typical Vessel Diameter | 2.5–3.5 mm |
| Recommended Serranator Sizes | 2.5-3.5 mm diameter; 40–120 mm length |
| Guidewire | 0.014" |
| Sheath | 5F-6F dependant of diameter |
Recommended Product: Serranator
2.5–3.5 mm diameter range, ideal for tibial vessel sizing.
Device Specifications for this Area:
PEDAL Arteries
The arteries the Serranator SL-PRO was built for.
Overview: Pedal artery revascularization represents the leading edge of limb salvage in CLTI. The dorsalis pedis, plantar arteries, and digital vessels are small, tortuous, heavily calcified, and among the most technically demanding vessels to access and treat. Yet for patients with CLTI, successful pedal revascularization can mean the difference between major amputation and preserved limb function.
The Serranator SL-PRO was purpose-engineered for exactly this anatomy. Its 2.0 mm diameter, 5F sheath compatibility, and enhanced trackability enable access to distal pedal vessels that would be unreachable with a standard BTK balloon. SRT's low-pressure mechanism then delivers controlled serration without the vessel trauma that risks occlusion in these delicate, end-organ vessels.
| Typical Vessel Diameter | 1.5–2.5 mm |
| Recommended SL-PRO Sizes | 2.0 mm; lengths 20 mm, 40 mm, 120 mm |
| Guidewire | 0.014" |
| Sheath | 5F |
Recommended Product: Serranator SL-PRO
60% more trackable than the Serranator.
Purpose-built for pedal and CLTI disease.
Device Specifications for this Area: