{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T10:47:51Z","timestamp":1770461271598,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Peripheral arterial disease (PAD) contains a significant proportion of patients whose main pathology is located in the infragenicular arteries. The treatment of these patients requires a deliberate consideration due to the threat of possible complications of an intervention. In this retrospective study, the feasibility of a below-the-knee atherectomy (BTKA) via a 1.5 mm Phoenix atherectomy catheter and the patient outcome over the course of 6 months are investigated. Materials and Methods: The data of patients suffering from PAD with an infragenicular pathology treated via 1.5 mm Phoenix\u2122 atherectomy catheter between March 2021 and February 2022 were retrospectively analyzed. Prior to the intervention, after 2 weeks and 6 months, the PAD stages were graded and ankle-brachial-indeces (ABI) were measured. Results: The study shows a significant improvement of ABI, both after 2 weeks and 6 months. Additionally, the number of PAD stage IV patients decreased by 15.2% over the course of 6 months, and 18.2% of the patients improved to PAD stage IIa. Only one bleeding complication on the puncture side occurred over the whole study, and no other complications were observed. Conclusions: Phoenix\u2122 atherectomy usage in the BTKA area seems to be feasible and related to a favorable outcome in this retrospective study.<\/jats:p>","DOI":"10.3390\/medicina58111594","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T04:00:51Z","timestamp":1667534451000},"page":"1594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of Feasibility and Patency of below the Knee Atherectomy Using the 1.5 mm Phoenix Catheter\u2014A Retrospective Study"],"prefix":"10.3390","volume":"58","author":[{"given":"Arun","family":"Kumarasamy","sequence":"first","affiliation":[{"name":"European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"},{"name":"Interventional Radiology, Krankenhaus Sachsenhausen, Schulstrasse 31, 60594 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-2913","authenticated-orcid":false,"given":"Alexander","family":"Gombert","sequence":"additional","affiliation":[{"name":"European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4205-9783","authenticated-orcid":false,"given":"Julia","family":"Krabbe","sequence":"additional","affiliation":[{"name":"Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Ruprecht","sequence":"additional","affiliation":[{"name":"Interventional Radiology, Krankenhaus Sachsenhausen, Schulstrasse 31, 60594 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanif","family":"Krabbe","sequence":"additional","affiliation":[{"name":"European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1161\/CIRCULATIONAHA.110.003954","article-title":"Secondary prevention and mortality in peripheral artery disease: National Health and Nutrition Examination Study, 1999 to 2004","volume":"124","author":"Pande","year":"2011","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/0895-4356(93)90091-E","article-title":"Segmental arterial disease in the lower extremities: Correlates of disease and relationship to mortality","volume":"46","author":"Vogt","year":"1993","journal-title":"J. Clin. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e012081","DOI":"10.1161\/JAHA.119.012081","article-title":"Adverse Events after Atherectomy: Analyzing Long-Term Outcomes of Endovascular Lower Extremity Revascularization Techniques","volume":"8","author":"Ramkumar","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jvs.2018.01.066","article-title":"A systematic review and meta-analysis of revascularization outcomes of infrainguinal chronic limb-threatening ischemia","volume":"68","author":"Almasri","year":"2018","journal-title":"J. Vasc. Surg."},{"key":"ref_5","first-page":"CD006680","article-title":"Atherectomy for peripheral arterial disease","volume":"9","author":"Wardle","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1161\/hc4201.097943","article-title":"Tibioperoneal (outflow lesion) angioplasty can be used as primary treatment in 235 patients with critical limb ischemia: Five-year follow-up","volume":"104","author":"Dorros","year":"2001","journal-title":"Circulation"},{"key":"ref_7","unstructured":"(2022, March 15). Atherectomy Devices Market: Global Industry Analysis and Forecast to 2018 to 2026. Persistence Market Research. Available online: https:\/\/www.persistencemarketresearch.com\/market-research\/atherectomy-devices-market.asp."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Vandenbroucke, J.P., von Elm, E., Altman, D.G., G\u00f8tzsche, P.C., Mulrow, C.D., Pocock, S.J., and Strobe Initiative (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040297"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ejvs.2017.07.018","article-title":"Editor\u2019s Choice\u20142017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)","volume":"55","author":"Aboyans","year":"2018","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jvs.2016.03.420","article-title":"Reporting standards of the Society for Vascular Surgery for endovascular treatment of chronic lower extremity peripheral artery disease","volume":"64","author":"Stoner","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_11","first-page":"e20190070","article-title":"WIfI classification: The Society for Vascular Surgery lower extremity threatened limb classification system, a literature review","volume":"19","author":"Duarte","year":"2020","journal-title":"J. Vasc. Bras."},{"key":"ref_12","unstructured":"(2022, June 14). AccessGUDID\u2014Device: Phoenix Atherectomy Catheter, 1.5 mm \u00d7 149 cm, 4F (00845225003166), Available online: https:\/\/accessgudid.nlm.nih.gov\/devices\/00845225003166."},{"key":"ref_13","unstructured":"Philips (2022, June 14). Phoenix Atherectomy System Hybrid Atherectomy System. Philips Healthcare. Available online: https:\/\/www.usa.philips.com\/healthcare\/product\/HCIGTDPHXAS\/phoenix-atherectomy-system-hybrid-atherectomy-system."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/j.jvs.2020.07.086","article-title":"A meta-analysis of mortality after minor amputation among patients with diabetes and\/or peripheral vascular disease","volume":"72","author":"Yammine","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1016\/j.jvs.2019.08.254","article-title":"Contemporary outcomes of infrapopliteal atherectomy with angioplasty versus balloon angioplasty alone for critical limb ischemia","volume":"71","author":"Zia","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.carrev.2020.08.041","article-title":"Laser Atherectomy for Infrapopliteal Lesions in Patients with Critical Limb Ischemia","volume":"23","author":"Kokkinidis","year":"2021","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1016\/j.jvs.2011.06.106","article-title":"A meta-analysis of the outcome of endovascular and noninvasive therapies in the treatment of intermittent claudication","volume":"54","author":"Ahimastos","year":"2011","journal-title":"J. Vasc. Surg."},{"key":"ref_18","first-page":"CD000990","article-title":"Exercise for intermittent claudication","volume":"12","author":"Lane","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2050312120929239","DOI":"10.1177\/2050312120929239","article-title":"Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization","volume":"8","author":"Mustapha","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20","DOI":"10.23736\/S0021-9509.21.12113-5","article-title":"The role of atherectomy in BTK lesions: A systematic review","volume":"63","author":"Pitoulias","year":"2022","journal-title":"J. Cardiovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/ccd.27897","article-title":"Atherectomy in below-the-knee endovascular interventions: One-year outcomes from the XLPAD registry","volume":"93","author":"Khalili","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.ejvs.2014.02.012","article-title":"Randomized Trials for Endovascular Treatment of Infrainguinal Arterial Disease: Systematic Review and Meta-Analysis (Part 2: Below the Knee)","volume":"47","author":"Jens","year":"2014","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.carrev.2017.09.014","article-title":"Percutaneous angioplasty versus atherectomy for treatment of symptomatic infra-popliteal arterial disease","volume":"19","author":"Abdullah","year":"2018","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s00380-020-01695-w","article-title":"Safety, effectiveness and mid-term follow-up in 136 consecutive patients with moderate to severely calcified lesions undergoing phoenix atherectomy","volume":"36","author":"Giusca","year":"2021","journal-title":"Heart Vessels"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"62","DOI":"10.23736\/S0392-9590.18.04051-8","article-title":"Diagnostic methods for measurement of peripheral blood flow during exercise in patients with type 2 diabetes and peripheral artery disease: A systematic review","volume":"38","author":"Eiken","year":"2019","journal-title":"Int. Angiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/11\/1594\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:10:19Z","timestamp":1760145019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/11\/1594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,3]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["medicina58111594"],"URL":"https:\/\/doi.org\/10.3390\/medicina58111594","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,3]]}}}