J Cardiovasc Interv.  2023 Oct;2(4):232-242. 10.54912/jci.2023.0005.

Retrograde Tibio-Pedal Access Technique

• Lee JH

• KMID: 2560949
• DOI: http://doi.org/10.54912/jci.2023.0005

Abstract

A significant number of patients with critical limb-threatening ischemia (CLTI) show steno-occlusion of below-the-knee (BTK) arteries. Recanalization is required for rapid wound healing in these patients. Interventional recanalization is preferred over surgical bypass due to anatomical characteristics of BTK arteries and patients’ comorbid conditions. However, such intervention is not easy because BTK lesions in CLTI patients are frequently accompanied by complex and calcified chronic total occlusion (CTO). Failure to recanalize these CTO lesions is major limitation of interventional procedures. Retrograde tibio-pedal access is the most promising technique when an antegrade approach is unsuccessful. This review focuses on basic concepts and advanced techniques of retrograde tibio-pedal access.

Keyword

Critical limb-threatening ischemia; Punctures; Arterial occlusive diseases; Tibial arteries