CRT 2026 | CUT-DRESS Trial: Lesion Preparation with Cutting Balloon

In-stent restenosis (ISR) continues to represent a relevant clinical challenge in contemporary coronary angioplasty practice. Despite advances in drug-eluting stents, neointimal hyperplasia and suboptimal stent expansion remain key determinants of long-term clinical outcomes. Therefore, adequate lesion preparation has become a fundamental element to optimize procedural results.

The CUT-DRESS study evaluated the impact of predilation with a cutting balloon (CB) compared with conventional balloon predilation prior to implantation of the Abluminus drug-eluting stent. This was an investigator-initiated randomized study in which patients were assigned, before lesion preparation, to a predilation strategy with either CB or a conventional balloon.

A total of 96 patients with coronary lesions suitable for treatment with the Abluminus stent were included. Patients with STEMI, left main coronary artery lesions, arterial or venous bypass grafts, chronic total occlusions (CTO), and complex in-stent restenosis were excluded.

The primary endpoints were post-procedural minimum stent area (MSA) and the percentage of neointimal hyperplasia at 9 months.

In the angiographic analysis, no significant differences were observed between the lesion preparation strategies. The MSA was 4.81 mm² in the conventional balloon group versus 5.92 mm² in the CB group, without reaching statistical significance (p=0.06).

Similarly, the percentage of neointimal hyperplasia at 9 months was comparable between both groups (12.7% vs 11.1%; p=0.188).

Read also: CRT 2026 | Clopidogrel vs Aspirin as Long-Term Monotherapy After Coronary Angioplasty.

Regarding the clinical outcomes at one year, the incidence of events was low and no significant differences were observed between the two strategies.

The CUT-DRESS study demonstrated that predilation with a CB before implantation of the Abluminus stent was not associated with a significant improvement in MSA or neointimal hyperplasia.