Critical limb ischemia (CLI) management has been dominated by endovascular advances in the last century. These advances include mostly below knee interventions, use of low profile balloons, crossing devices, and reentry devices. The latest paradigm change in preventing amputation in CLI patients is utilization of pedal artery access. Pedal artery access of the tibioperoneal vessels and combination access along with femoral artery have maximized recanulation rates. Pedal artery access requires knowledge of access via duplex ultrasound and a plan for access management. Advances in pedal artery access include use of dual artery access to maximize angiosome-based interventions. Critical limb ischemia operators should become familiar with this novel technique so that revascularization attempts in CLI patients are maximized.
Links:
[1] http://www.vasculardiseasemanagement.com/printmail/1249
[2] http://www.vasculardiseasemanagement.com/print/1249