Mini S Feasibility Study With Shockwave Medical Mini S Peripheral IVL System

Inclusion Criteria:

-General Inclusion Criteria

1. Age of subject is ≥ 18 years.
2. Subject is able and willing to comply with all assessments in the study.
3. Subject or subject's legal representative has been informed of the nature of thestudy, agrees to participate, and has signed the approved consent form.
4. Estimated life expectancy > 1 year.
5. Rutherford Clinical Category 2, 3, 4 or 5 of the target limb(s).

• Angiographic Inclusion Criteria

6. One or two target lesion(s) located in a native de novo superficial femoral, poplitealor infrapopliteal artery (above the ankle joint), in one or both limbs.
7. Target lesion reference vessel diameter (RVD) between 2.0 mm and 7.0 mm byinvestigator visual estimate.
8. Target lesion stenosis ≥70% (for vessels below the knee defined as P3 to the anklejoint) or ≥90% (for vessels above the knee) by investigator visual estimate.
9. Target lesion length is ≤150 mm by investigator visual estimate. Target lesion can beall or part of the 150 mm treated zone.
10. Calcification is at least moderate defined as presence of fluoroscopic evidence ofcalcification: 1) on parallel sides of the vessel and 2) extending > 50% the length ofthe lesion if lesion is ≥50mm in length; or extending for minimum of 20mm if lesion is <50mm in length.

Exclusion Criteria:

• General Exclusion Criteria

1. Rutherford Clinical Category 0, 1 and 6 (target limb).
2. History of endovascular or surgical procedure on the target limb within the last 30days, or planned within 30 days of the index procedure. Note: inflow treatment ofnon-target lesions is allowed providing successful treatment.
3. Subject in whom antiplatelet or anticoagulant therapy is contraindicated.
4. Subject has known allergy to contrast agents or medications used to performendovascular intervention that cannot be adequately pre-treated.
5. Subject has known allergy to urethane, nylon, or silicone.
6. Myocardial infarction within 60 days prior to enrollment.
7. History of stroke within 60 days prior to enrollment.
8. Subject has acute or chronic renal disease with eGFR <30 ml/min/1.73 m2 (using CKD-EPIformula), unless on renal replacement therapy.
9. Subject is pregnant or nursing.
10. Subject is participating in another research study involving an investigational agent (pharmaceutical, biologic, or medical device) that has not reached the primaryendpoint.
11. Subject has other medical, social or psychological problems that, in the opinion ofthe investigator, preclude them from receiving this treatment, and the procedures andevaluations pre- and post-treatment.
12. Covid-19 diagnosis within 30 days.
13. Planned use of cutting/scoring balloons, re-entry or atherectomy devices in targetlesion(s) during the index procedure.
14. Planned major amputation of target limb.
15. Acute limb ischemia.
16. Occlusion of all the inframalleolar outflow arteries/vessels (i.e., desert foot).
17. Subject already enrolled into this study.

• Angiographic Exclusion Criteria

18. Failure to treat clinically significant inflow lesions in the ipsilateral iliac,femoral, or popliteal arteries with ≤30% residual stenosis, and no seriousangiographic complications (e.g. embolism).
19. Failure to successfully treat significant non-target infra-popliteal lesions, iftreated prior to target lesion(s). Successful treatment is defined as obtaining ≤50%residual stenosis with no serious angiographic complications (e.g., embolism).
20. Target lesion includes in-stent restenosis.
21. Evidence of aneurysm or thrombus in target vessel.
22. No calcium or mild calcium in the target lesion.
23. Target lesion within native or synthetic vessel grafts.
24. Failure to successfully cross the guidewire across the target lesion; successfulcrossing defined as tip of the guidewire distal to the target lesion in the absence offlow limiting dissections or perforations.