case_images: PMC10498688_01
case_images: Case 1. (A) An ASAHI Mongo wire crosses a total occlusion of the right proximal ATA. (B) Pilot channel through the lesion created by Phoenix 1.5 mm catheter with a front-end cutting technique. (C) Post atherectomy, an IVUS catheter and an appropriately sized balloon can pass the lesion. (D) Final angiogram showing 0% residual stenosis and TIMI 3 flow as compared to the initial angiogram.. ATA, anterior tibial artery; TIMI, thrombolysis in myocardial infarction; IVUS, intravascular ultrasound.
case_images: 10.1177_2050313X231198370-fig1.jpg
case_images: PMC10498688_01_10.1177_2050313X231198370-fig1.jpg
case_images: fig1-2050313X231198370
case_images: An ASAHI Mongo wire (ASAHI INTECC) was used to cross the lesion and advanced up to the P1 segment of the popliteal artery (Figure 1(a)). A 0.035" Armada XT (Abbott) balloon ruptured in the lesion when inflated. After these unsuccessful attempts to cross the lesion, the Phoenix 1.5 mm catheter was advanced into the lesion, successfully traversing it while also debulking and modifying the severe calcification (Figure 1(b)), enabling intravascular ultrasound (IVUS) imaging with a Volcano 0.014" IVUS catheter (Philips; Figure 1(c)). After balloon angioplasty, the final angiogram showed 0% residual stenosis and TIMI 3 flow (Figure 1(d)) with no complications.
case_images: PMC10498688_02
case_images: Case 2. (A) The Phoenix 1.5 mm catheter creates a pilot channel through an occlusion in the mid segment of the right ATA that the triaxial catheter system could not cross. (B) Final angiogram of the right ATA showing 20%-30% stenosis and TIMI 3 flow with no complications after balloon angioplasty through the pilot channel. (C) The 1.5 mm catheter debulks a focal occlusion in the proximal dorsalis pedis artery. (D) Final angiogram of the dorsalis pedis artery with TIMI 3 flow into the foot after balloon angioplasty.. ATA, anterior tibial artery; TIMI, thrombolysis in myocardial infarction
case_images: 10.1177_2050313X231198370-fig2.jpg
case_images: PMC10498688_02_10.1177_2050313X231198370-fig2.jpg
case_images: fig2-2050313X231198370
case_images: After these unsuccessful attempts to cross the lesion, the Phoenix 1.5 mm catheter was advanced into the lesion, successfully debulking and modifying the calcification (Figure 2(a)), allowing angioplasty with a 2.5 mm x 120 mm Jade balloon (CSI) to pre-dilate the lesion (Figure 2(b)). Extravascular ultrasound showed a heavily calcified spot in the proximal dorsalis pedis artery, so the Phoenix atherectomy device was used a third time to debulk the lesion (Figure 2(c)). After balloon angioplasty, the final angiogram showed residual stenosis of 20%-30% and TIMI 3 flow with no complications (Figure 2(b) and (d)).