Crossing complex infrapopliteal lesions utilizing a front-end cutting technique: A report of two cases with a novel rotational atherectomy device

Critical limb ischemia represents the most severe stage of peripheral vascular disease and patients often present with complex, calcified infrapopliteal lesions. Atherectomy is an endovascular treatment modality that can be used to debulk otherwise uncrossable lesions. We performed a retrospective, single-center, case report of two patients who presented with critical limb ischemia and whose complex and calcified infrapopliteal lesions were treated with the 1.5 mm Phoenix Atherectomy System after prior failed angioplasty attempts. The 1.5 mm Phoenix Atherectomy System successfully debulked each infrapopliteal lesion, and each patient achieved thrombolysis in myocardial infarction grade 3 flow of the target lesion. There were no device-related procedural complications or deaths. These cases demonstrate that the Phoenix Atherectomy System can be used to debulk complex, calcified infrapopliteal lesions to optimize endovascular treatment and improve outcomes for patients with critical limb ischemia. Further studies are warranted to validate the long-term safety and efficacy rates of the Phoenix Atherectomy System in a larger critical limb ischemia population.