Transpedal Approach in Failed Antegrade Attempt of Lower Limb Peripheral Arterial Disease—A Review with Different Treatment Strategies

Abstract

Transpedal access is an evolving technique primarily used in patients after failed femoral antegrade approach to revascularize complex tibiopedal lesions. In patients who are at high risk for surgery the transpedal access may be the only option in failed antegrade femoral access to avoid amputation of the limbs. In recent years transpedal access is used routinely to revascularize supra-popliteal lesions due to more success and less complications over femoral artery approach. Retrograde approach parse will not give success in all cases and importantly success depends on techniques used. There are different techniques that need to be used depending on lesion characteristics, comorbidities, and hardware available to improve success with less complications. This review provides different strategies for successful treatment of iliac and femoral artery lesions by transpedal approach after failed antegrade femoral attempt.

Transplantation of endothelial progenitor cells derived exosomes improve angiogenesis in a rat hindlimb ischemia model

“…LLI refers to lower limbs insu cient blood perfusion caused by various reasons, resulting in intermittent claudication, skin ulcers, and even gangrene and amputation [13] . Currently, the main treatment option of LLI is surgical or endovascular revascularization to restore the limb blood perfusion, but the results were often not satisfactory and many patients could not accept the invasive therapy [14] . In recent years, therapeutic angiogenesis technology based on stem cell transplantation was a worthwhile method to LLI patients especially which could not accept surgical or endovascular revascularization [15] .…”