Vessel Preparation with Longitudinal and Controlled-Depth Micro-Incisions

Percutaneous transluminal angioplasty (PTA) is the standard endovascular treatment for peripheral artery disease. To reduce acute procedural complications and optimize long-term clinical response, vessel preparation has become more common to modify plaque and increase luminal gain prior to PTA. Innovative methods for vessel preparation are specifically needed for long, complex lesions that may involve more time, additional equipment, and increased risk for long-term complications. The FLEX Vessel Prep™ (FLEX VP) System is a novel device designed to modify plaque, improve vessel compliance, and facilitate drug delivery by creating longitudinal, controlled-depth, circumferential micro-incisions along the entire length of a lesion using a retrograde pullback approach. FLEX VP is currently indicated for use with PTA catheters to facilitate dilation of stenoses in the femoral and popliteal arteries. This chapter describes FLEX VP’s mechanism of action and summarizes current clinical results in patients with peripheral arterial disease. The FLEX VP System provides safe plaque modification and vessel preparation via consistent, controlled-depth, circumferential micro-incisions in complex, mixed morphology lesions.