Achieving Luminal Gain in BTK
Vincent Varghese, DO
Deborah Heart and Lung Center
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Critical limb ischemia (CLI) patients are among the sickest, with the highest risk of losing their limbs. Achieving good results in these cases is particularly challenging due to the diffuse, small-vessel nature of below-the-knee disease.
Serranator offers a strong option for these patients by providing luminal gain while minimizing the risk of dissection. I’ve been using Serranator in 80–90% of my below-the-knee cases and have consistently seen good results.
I’ve used it even in heavily calcified vessels—if I can cross the occlusion luminally, Serranator’s deliverability allows reliable treatment, with strong luminal gain and a low risk of dissection. This often eliminates the need for stenting.
When I first saw the device, I was a bit skeptical about whether it would provide great results. But in practice, I’ve been able to achieve excellent luminal gain in very challenging lesions, with minimal risk of dissection or bailout stenting.
The key benefit of the Serranator balloon lies in its deliverability. Its low profile allows it to reach lesions effectively, which is an advantage over other scoring balloons. When appropriately sized—potentially using IVUS in combination with its technology—you can achieve very good results in difficult below-the-knee interventions.
