Abstract
Endovascular therapy (EVT) has been recognized as a useful and low invasive technique for treating the patients with critical limb ischemia. Antegrade ipsilateral approach is needed to recanalize chronic total occlusions of the superficial femoral artery and lower leg arteries. Ipsilateral approach is not difficult and not troublesome if the operator is familiar with this procedure. To recanalize long chronic total occlusion, a bidirectional approach is quite useful. Additional distal puncture is needed in some cases. Trans-collateral wiring and catheterization can be done in some cases. Once the wires pass through the total occlusion, balloon angioplasty can be done without difficulty. Though the long-term patency of these recanalized arteries is not satisfactory, it is enough that those arteries are kept opened until wound healing is achieved. EVT has an important role in the treatment of critical limb ischemia.
