Evaluating Plaque Photoablation Using an Excimer Laser in Patients With Lower Extremity Vascular Disease

Inclusion Criteria: * signed informed consent * symptomatic infrainguinal lower extremity vascular disease (Rutherford category 3, 4, 5 or 6), stable for at least 2 weeks prior to study inclusion * lesions in the superficial femoral artery (SFA), popliteal, or infrapopliteal arteries at least one angiographically identifiable infrageniculate artery * patients must be poor surgical candidates, indicated by at least one of the following conditions: * absence of venous autologous grafts (that is, lack of a suitable vein to use for bypass) * poor (diffusely diseased or \<=1mm diameter) or no distal vessels available for graft anastamosis * high risk of surgical mortality, evidenced by American Society of Anesthesiologists Physical Class 4 or higher Exclusion Criteria: * age below 18 years * pregnancy, or plan to become pregnant * participation in another cardiovascular or peripheral vascular study * myocardial infarction (MI) in prior month * stents at treatment site * disorders or allergies precluding use of radiographic contrast * renal insufficiency sever enough to contraindicate use of radiographic contrast * contraindication to treatment with anticoagulants * untreated ipsilateral iliac stenosis \>70% * inability or unwillingness of the patient to comply with intended examinations * unavailability of required procedural or imaging equipment * lesion located in a graft * hemodynamically significant arrhythmia or left ventricular ejection fraction \<20% * life expectancy le…