Peripheral artery disease (PAD) affects more than 200 million patients worldwide [1]. Endovascular interventions are now the first treatment option for the majority of femoropopliteal (FP) and below-the-knee (BTK) lesions [2]. However, specific lesion characteristics, such as heavy calcification, long lesions, in-stent restenosis (ISR), and chronic total occlusions (CTOs), pose challenges for endovascular treatment due to both difficulty in crossing and reduced long-term patency [[3], [4], [5], [6], [7], [8], [9]]. Atherectomy devices are commonly used in peripheral interventions for the treatment of these complex lesions [10,11]. Currently available devices include, among others, excimer laser atherectomy (Philips, Colorado Springs, Colorado), orbital atherectomy (Cardiovascular Systems, Inc., St. Paul, Minnesota), directional atherectomy (Medtronic, Minneapolis, Minnesota), and rotational atherectomy (Boston Scientific, Marlborough, Massachusetts). Atherectomy is used for complex lesions for a number of reasons, including increasing arterial compliance to minimize the likelihood of subsequent dissection, modifying plaque for better balloon and/or stent expansion, increasing drug absorption by the vessel wall, and removing thrombotic burden [[12], [13], [14], [15]].