Systems, devices and methods for treating a stenosed vessel or heart valve are disclosed. In some embodiments, a cutting/scoring assembly/device for treating a stenosed vessel/heart valve is provided and includes a main, elongated scoring sleeve or element with multiple longitude wires arranged at a distal end. A distal end of the elongated element is proximal to the multiple longitude wires which, when used in conjunction with a balloon catheter, is used to for, according to some embodiments, localized controlled longitudinal vessel incision.