EXCimEr Laser for Long lENgTh Lesions in Below-The-Knee Arteries Study

Inclusion Criteria: * The treatment vessel is DeNovo * Stenotic (\>50%) or occlusive atherosclerotic disease of infrapopliteal artery(s) * Length of target lesion is \> 50 mm * Reference target vessel diameter between 2-4.0 mm by visual assessment * Documented Rutherford Class 4 or 5 symptomatic critical limb ischemia * The patient must be \>18 years of age * Life-expectancy of more than 12 months * The patient has no child bearing potential or negative serum pregnancy test within 7 days of the index procedure * The patient must be willing and able to return to the appropriate follow-up times for the duration of the study * The patient must provide written patient informed consent that is approved by the ethics committee * Anatomic Inclusion Criteria * All inflow lesions successfully (\<30 residual stenosis) treated prior to target lesion treatment during same procedure or according standard of care without unresolved complications * At least one angiographically visible target at the ankle for establishment of straight line flow. Exclusion Criteria: * Patient refusing treatment * The target vessel segment diameter is not suitable for available catheter design. * Unsuccessfully treated endovascular or bypass( \>30% residual stenosis) proximal ( iliac, SFA, popliteal) inflow limiting arterial/graft stenosis * Lesion lies within or adjacent to an aneurysm * The patient has a known allergy to heparin, Aspirin or other antiaggregant therapies or a bleeding diatheses or is unable, or unwilling, to tolerate such therapies. * The patient has a history of prior life-threatening contrast media reaction. * The patient is currently enrolled in another investigational device or drug trial. * The patient is currently breast-feeding, pregnant or intends to become pregnant. * The patient is unable to provide informed consent * The patient has end stage renal disease (currently on any form of dialysis) * Known Left Ventricular Ejection Fraction \< 35% * The patient has had an MI within 30 days prior to enrollment * The patient has had a CVA within 90 days prior to enrollment * Serum Creatinine \> 150 µmol * The patient has a previous bypass in the target limb * The patient has a current systemic infection