This report features 2 cases of vessel preparation where the Rotarex S rotational atherothrombectomy device induced arterial wall ruptures and describe how the ruptures were treated in 2 different ways. 

It appears that novel guidelines may be needed to assess the ischemic pedal flow. These novel diagnostic scales should associate multilevel arterial branching disease classification, standardized calcification indexation, and commonly accepted hemodynamic foot-flow evaluation.