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Tibial-pedal arterial access & retrograde interventions for advanced peripheral arterial disease & critical limb ischemia

JA Mustapha, LJ Diaz-Sandoval & F Saab

The incidence of peripheral arterial disease is rising thanks to increasing rates of obesity, diabetes, hypertension and failed attempts at controlling tobacco abuse. Advanced peripheral arterial disease and critical limb ischemia represent the terminal stages and carry high amputation and mortality rates. Evolving technology and understanding of the disease process have introduced newer therapeutic modalities and approaches to peripheral vascular interventions. Among these, retrograde tibialpedal access and minimally invasive retrograde interventions are gaining momentum as new adopters are witnessing the safety and improved outcomes (evidenced by the increased success rate of previously failed attempts at crossing complex occlusions via the traditional antegrade approach). The shift toward less invasive approaches has led to increased endovascular interventions and decreased amputation rates.