Percutaneous retrograde tibial access in limb salvage.
OBJECTIVE
To describe a novel technique for percutaneous retrograde access of the tibial vessels after antegrade access failure in patients with chronic limb-threatening ischemia.


METHODS
Six patients who had failed antegrade access to infrapopliteal occlusions had attempted retrograde tibial puncture and wire passage into the proximally patent vessel. Endovascular intervention was carried out utilizing standard techniques. The patients were followed for functional class and wound healing.


RESULTS
All six patients were successfully recanalized. Five patients experienced rapid and dramatic healing of wounds that had previously been refractory to conservative therapy. The other patient did not experience healing and ultimately died of progressive intractable congestive heart failure in the setting of a severe ischemic cardiomyopathy.


CONCLUSIONS
Retrograde tibial access can be a valuable technique in the armamentarium of a peripheral interventionist treating patients with chronic critical limb ischemia.
Botti
Charles F
CF
MidOhio Cardiology and Vascular Consultants, Inc., Columbus, Ohio 43214, USA. cfbotti@yahoo.com
Ansel
Gary M
GM
Silver
Mitchell J
MJ
Barker
Billie J
BJ
South
Sheila
S
D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D011677:Punctures; D016909:Tibial Arteries