Scoring Angioplasty Platform Treats Peripheral Artery Disease

An innovative metal-alloy scoring sheath facilitates dilation of stenotic atherosclerotic material in the peripheral vasculature.

The Transit Scientific (Park City, UT, USA) XO Score platform is designed to aid low-pressure lesion dilatations in patients with peripheral artery disease (PAD), including in the popliteal, infrapopliteal, and renal vasculature, as well as in both native and synthetic arteriovenous (AV) dialysis fistulae. The low-profile, flexible, metal-alloy exoskeleton has 22 scoring struts (0.25mm, 0.35mm, or 0.50mm deep) that enable precise dilation across a range of lesion types, using standard off-the-shelf percutaneous transluminal angioplasty (PTA) balloons.

The struts, which lay flat during insertion, rotate 90° into function during balloon inflation in order to score the vessel walls, and then rotate 90° back during deflation. The XO Score is available in 6.3Fr diameter and 65cm or 125cm working lengths, and can be used with a number of 4-8mm diameter and 20-40mm long PTA balloons. Future ultra-low-profile over-the-wire and rapid-exchange versions are under development for smaller vessels and for coronary use.

“The rotating struts allow clinicians to vary scoring depth without increasing device profile. We've been thrilled to see the effective low-pressure dilatation and luminal gain achieved using our XO Score platform to treat a broad range of lesion types,” said Greg Method, President of Transit Scientific. “XO Score offers a direct value proposition; One XO Score and an off-the-shelf PTA balloon will cost less than one specialty PTA scoring or cutting technology.”

“We need novel, safe, and appropriately aggressive vessel prep devices to continue fighting the increasingly difficult stenotic lesions encountered in critical limb ischemia patients,” commented Jihad Mustapha, MD, of Advanced Cardiac & Vascular Center (Grand Rapids, MI, USA). “The ability to scale this technology down to below 3Fr is especially important for treatment of pedal loop stenosis and deployment in the tibiopedal junction.”

PAD is caused by atherosclerosis, and results in severe pain in the feet or toes, even while resting, due to poor circulation. Complications include sores and wounds that will not heal in the legs and feet that if left untreated, could result in amputation of the affected limb. CLI is a severe blockage in the arteries of the lower extremities, which markedly reduces blood-flow; it is a serious form of PAD, but less common than claudication.

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