Indeed. The first 186 sample that Maxim sent me was one of those but 20 lead. I flapped around with it a bit before deciding that the SO 1.27mm pitch was the smallest I could contemplate. They were good enough to send me a DIP package as well.
I wonder if there really is any real space gain from using these small chips. The external components need to be further away relatively in order for the leads to have the room to flare out and connect. Plus as you say, there is no room for traces between legs.
I guess its all 4 layer and up.
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