Retrograde tibial anterior approach for challenging popliteal occlusion in CLI patient

This case report describes the endovascular treatment of a challenging popliteal occlusion in a CLTI patient. The lesion couldn’t be crossed via antegrade approach. The retrograde approach by puncture the mid section of the anterior tibial artery is safe and allowed us to recanalize the lesion easily.


    MD, MHM Nicola Troisi
    September 1, 2018

    Nice case, thank you for sharing. Just one short comment. There is no foot picture. Neither pre nor post revascularization. The foot circulation is guaranteed by ATA? Is it enough? Otherwise, you could even consider antegrade revasculatization of PTA

    MD Michel Bosiers
    September 3, 2018

    Good job!
    To answer some of your questions, i would have stented the entire subintimal part, to treat those dissections, but thats just me.
    Regarding the vasospasm of the ATA, i would treat it just like you, there is no need for ballooning, and if it looks better after your papaverine injection, i would leave it like it is.

    Dr Maxime Elens
    September 12, 2018

    Thank you both for your comments: The foot was vascularised by the ATA only, CTO of the entire PTA, that’s why no retrograde PTA approach could be considered.

Leave a Reply