Going Retrograde First: Crossing Occlusions

Figure 1. Below-knee runoff, right leg. Note the heavily diseased TP trunk with complex appearing plaque.

Figure 1. Below-knee runoff, right leg. Note the heavily diseased TP trunk with complex appearing plaque.

In this month’s post on “Vascular Access: The VDM Clinician Blog” by Ajay Mhatre, MD, and Richard Heuser, MD, FACC, FSCAI, FACP, FESC, the authors describe a case of a 78-year-old man with critical limb ischemia of the right foot with a nonhealing ulcer of the right lateral malleolus. Findings of the angiography showed an occluded right anterior tibial artery with reconstitution distally and moderate to severe complex appearing calcified plaque in the tibial peroneal trunk. This influenced Dr. Mhatre and Dr. Heuser to try crossing the lesion retrograde with access via the right posterior tibial artery.

Read “Retrograde Crossing: When the Front Door Is Locked, Look for Another Way In!” for intraprocedure images and description of the case.

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