Retrograde Tibiopedal Access as a Bail-Out Procedure for End
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Introduction
Retrograde pedal access has been well described in the literature as a secondary approach for limb salvage either in critical limb ischemia (CLI) patients after failure of antegrade femoral approach or in patients who are not candidates for the antegrade approach. In this manuscript we are presenting a case where retrograde tibiopedal access has been used as a bail-out procedure for the management of superficial femoral artery (SFA) intervention complications.

Case Presentation
A 76-year-old female with history of diabetes mellitus, hypertension, coronary artery disease, and smoking was complaining of intermittent severe claudication in her left leg with a Rutherford classification of 3. Left leg ABI was 0.61.

Procedure/Technique
Preintervention angiogram showed totally occluded mid SFA that reconstitutes to the distal SFA, which was patent as shown in Figure 1. While trying to cross the totally occluded mid SFA using the conventional CFA access, a perforation developed exactly just before the lesion as shown Figure 2. The wire was exchanged with Glidewire Gold in an attempt to cross the lesion without success in crossing the lesion....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075623/
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