The scoring balloon used for lesion preparation (Fig. 1) consists of three non-slip scoring elements with triangular cross sections (Lacrosse NSE Nipro/Goodman, Nagoya, Japan/NSE Alpha B.Braun Melsungen AG, Germany). The device was used in one length only (13 mm). Balloon diameters were available from 2.00 to 4.00 mm. Calcified lesion modification with this device, as measured by optical coherence tomography, was favorably rated in previous observational studies [18 (link)]. Given the fact that there is no class effect for DCB devices [4 (link)] the iopromide–paclitaxel-coated DCB was used (SeQuent® Please NEO, B.Braun Melsungen AG). As compared to the predecessor device (SeQuent® Please, B.Braun Melsungen AG), a hydrophilic coating of the distal shaft was introduced for enhanced lesion crossability.

Scoring balloon catheter with three nylon elements having a triangular cross section of height 0.39 mm, bonded distally and proximally of the balloon (left panel, courtesy Nipro Corporation, Japan). When the balloon is inflated, the three non-slip elements are positioned on the cylindrical surface of the balloon spaced with 120° from each other (right panel)