title: Percutaneous Femoropopliteal Recanalization Using a Completely Transpedal/Transtibial Approach.
abstract: OBJECTIVE
  To report preliminary experience with femoropopliteal revascularization using a completely transpedal/transtibial approach.
  
  
  METHODS
  Three patients with Rutherford 3-4 disease underwent revascularization of TASC C/D lesions using a pedal/tibial artery as the only site of arterial access.
  
  
  RESULTS
  One patient with a chronic superficial femoral artery occlusion had continuity achieved to the common femoral artery using a dedicated reentry device and stenting; in a second patient, an occluded popliteal artery stent was successfully revised with an endograft; and in a third patient with morbid obesity, a chronic SFA occlusion was successfully stented. All patients experienced complete resolution of presenting symptoms; no puncture site complications were seen.
  
  
  CONCLUSIONS
  Use of a pedal/tibial approach as the sole site of arterial access may become an important access technique for femoropopliteal revascularization when patients have limited femoral access options.
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Penn Presbyterian Medical Center, University of Pennsylvania Medical Center, 39th and Market Streets, Philadelphia, PA, 19104, USA. timothy.clark@uphs.upenn.edu.
authors.forename: Timothy W I
authors.initials: TW
authors.lastname: Clark
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Penn Presbyterian Medical Center, University of Pennsylvania Medical Center, 39th and Market Streets, Philadelphia, PA, 19104, USA.
authors.forename: Micah M
authors.initials: MM
authors.lastname: Watts
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Tak W
authors.initials: TW
authors.lastname: Kwan
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Arterial access; Chronic total occlusions; Endovascular; Recanalization; Transpedal