Retrograde percutaneous transmetatarsal artery access: New approach for extreme revascularization in challenging cases of critical limb ischemia

摘要

Critical limb ischemia (CLI) occurs as a result of progressive obstructive atherosclerosis, which is most closely associated with tibial and foot arteries disease. Currently revasculari-sation is the first-line treatment of CLI and foot salvage, including restoration of arterial blood flow, to achieve relief of at-rest pain and improve wound healing [1].In recent years, due to good clinical results there has been growing acceptance of endovascular therapy as a primary therapeutic strategy for infrapopliteal lesions and CLI, especially in patients at high risk or with contraindications to surgical revascularization [2-6]. Advancements in endovascular technologies have lead to an increasing use of interventional techniques to restore blood flow with high rates of technical success and limb salvage. However, in our daily interventional practice we encounter,challenging cases in which the known technical-solutions fail and thus require innoyative and extreme technical strategies to restore blood flow to the foot.