Management of Critical Lower Limb Ischemia through Transpedal Approach
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- Category: Vol. 83, September 2015
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Management of Critical Lower Limb Ischemia through Transpedal Approach, HANY A. MOHAMED, AHMED A. SHAKER and AMR ABD EL-RAHIM
Abstract
Introduction: Until recently, the inability to cross tibial lesions in an antegrade fashion was accepted as a failure of interventional therapy and an indication for an open surgical approach.
In 1990, Iyer and colleagues described the use of a retro-grade pedal/tibial approach to handle cases in which the conventional way of crossing the tibial lesion had failed.
Aim of the Work: To assess transpedal approach in vessel recanalization on failure of re-entry to distal true lumen during antegrade approach or in presence of limited patent distal artery.
Patients and Methods: The study was performed on 14 limbs in 14 patients with critical lower limb ischemia for whom percutaneous transluminal angioplasty was failed via antegrade approach.
Results: By using transpedal approach, clinical success rate after the procedure which was detected by immediate regaining of the pulse or clinical improvement was 13 cases from 14 cases (92.85%).
Conclusion: Transpedal approach is an ideal line of intervention in failure of re-entry of subintimal angioplasty or limited patent distal part of arterial tree.