An Extreme Recanalization: Transcollateral Retrograde Wiring for Below-the-ankle Occlusive Lesion

Abstract

For critical limb ischemia patients, although presence of below-the-ankle (BTA) disease is an independent predictor of major amputation, recanalization techniques for BTA disease have not been standardized. We report a case of successful Endovascular therapy (EVT) using transcollateral retrograde approach for a BTA occlusive lesion. EVT for BTA disease is challenging. When the antegrade approach fails, pedal or metatarsal puncture is one of the options for retrograde wiring. However, these vessels are sometimes not suitable candidates for the puncture. In such situations, a trans-collateral retrograde approach is one of the optional techniques for below the ankle recanalization.