Crossing complex infrapopliteal lesions utilizing a front-end cutting technique: A report of two cases with a novel
Siddhartha Rao1, Anton Hnatov1, Trisha Tarra2
1Vascular Solutions of North Carolina, Cary, NC, USA.
Insights
The Phoenix Atherectomy System effectively treated complex, calcified infrapopliteal lesions in critical limb ischemia patients, restoring blood flow. This endovascular approach offers a promising solution for previously untreatable lesions.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Peripheral Vascular Disease
Background:
- Critical limb ischemia (CLI) is the most severe stage of peripheral vascular disease, often involving complex, calcified infrapopliteal lesions.
- Atherectomy is an endovascular technique used to remove plaque buildup and facilitate treatment of otherwise uncrossable lesions.
Observation:
- This retrospective case report details the treatment of two CLI patients with complex, calcified infrapopliteal lesions.
- Both patients had previously undergone failed angioplasty attempts.
- The 1.5 mm Phoenix Atherectomy System was utilized to debulk these challenging lesions.
Findings:
- The Phoenix Atherectomy System successfully debulked the infrapopliteal lesions in both patients.
- Both patients achieved Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow in the target vessels post-procedure.
- No device-related complications or procedural deaths were reported.
Implications:
- The Phoenix Atherectomy System demonstrates potential for treating complex, calcified infrapopliteal lesions in CLI patients.
- This approach can optimize endovascular treatment and improve outcomes for patients with severe peripheral vascular disease.
- Further research is needed to confirm the long-term safety and efficacy of the Phoenix Atherectomy System in a larger CLI patient cohort.
Abstract:
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.
