Percutaneous Retrograde Tibial Access in the Endovascular Treatment of Acute Limb Ischaemia: A Case Report

Abstract

The utilization of a retrograde tibial approach in lower limb endovascular therapy has been described in the published literature. In this article we report our recent experience in order to highlight this valuable and under-utilised technique, which was successful in a difficult case where a conventional approach failed.

Ultrasonography-guided retrograde tibial artery puncture for recanalization of complex infrainguinal arterial occlusions

“…Retrograde tibial artery recanalization of infrainguinal complex occlusions have been rarely reported in the literature; therefore, only a very small number of cases or individual reports without long follow-up are available (2,(10)(11)(12)(13)(14). Some small series and case series have reported a success rate of 100% for retrograde tibial artery recanalization (2,12).…”

Retrograde Pedal/Tibial Artery Access for Treatment of Infragenicular Arterial Occlusive Disease

“…The use of the pedal/tibial retrograde approach for the treatment of infrageniculate arterial occlusive disease has been reported only in case reports and some small case series. 4,6,7,9,[11][12][13] Botti and colleagues presented a series of six cases in which the retrograde pedal approach was attempted for critical limb ischemia with ulceration and failed antegrade recanalization of at least one tibial vessel runoff to the foot. 13 Access was obtained through the posterior tibial artery in four patients and through the dorsalis pedis artery in two patients.…”

“…5 Early in the experience, access into the pedal vessels was obtained via a cut down and was accomplished later on using direct percutaneous arterial puncture. [6][7][8][9] In this article we present the technical details of this approach and review the published data on its use in this challenging patient population.…”

Midterm Outcomes After Infrapopliteal Interventions in Patients With Critical Limb Ischemia Based on the TASC II Classification of Below-the-Knee Arteries

“…Several case series have also recently demonstrated successful recanalization of occluded tibial lesions through retrograde pedal access, with minimal procedure-related complications. [13][14][15][16][17] This and other retrograde techniques may be an option to consider in CLI patients with TASC C/D infrapopliteal lesions that cannot be crossed using standard antegrade strategies due to disease complexity.…”