Serranator and Plaque Modification
Sarang Mangalmurti, MD
Bryn Mawr Hospital
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So the Serranator is a specialty balloon that has a very unique mechanism of plaque modification. When the balloon is inflated, there are metal strips that will engage the plaque in a serration fashion. You're maximizing the amount of surface area that's cutting into the plaque, and you're increasing the amount of pressure that is being exerted at the focal points of the Serranator edges.
There are other tools that we will use in conjunction prior to Serranator. Atherectomy can be very helpful to create a channel through which we can then introduce the Serranator balloon and then perform your angioplasty. So that's a good combination therapy that works for a lot of patients. But plaque modification is important, in particular to try to expose as much smooth muscle as possible for drug absorption.
And Serranator is a very effective tool for being able to modify the plaque through angioplasty so that you can, in theory, optimize or improve the uptake of drug, which is your final step in the process of treating these patients' stenoses. So the Serranator is better balloon angioplasty, plain and simple. So I use it whenever I want to try to get the best angioplasty results that are possible for a given area in the vascular bed.
