Abstract:

Aim: was to determine indications for use of the technique of retrograde recanalization of the occluded portion of the artery through tibial collateral branches.

Materials and methods: 71 years old patient, was admitted with complaints of pain at rest in the right foot, cold, lack of sensitivity of fingers of both feet, blackening of hallux of the right foot with ischemic gangrene of 1 toe of right foot. Multislice computed tomography angiography of lower limbs revealed shin artery occlusion on both sides. Regional systolic pressure (RSP) on the right anterior tibial artery (ATA) - 80 mm Hg., (ancle-brachial index (ABI) = 0.55) for posterior tibial artery (PTA) - 50 mm Hg., (ABI = 0.33). Diagnostic angiography: fibular artery and PTA occlusion throughout, occlusion of proximal and middle parts of ATA. We performed retrograde recanalization of the occluded artery of the transcollateral approach

Results: ATA patency restored all the way to the foot. RSP to ATA 140 mm Hg., (ABI = 0.9) for PTA RSP was 100 mm Hg., (ABI = 0.6).

Conclusions: transcollateral approach is an additional method of revascularization, which increases the rate of technical success after a failed antegrade revascularization, and this method can be an alternative to the retrograde approach.

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