Fig. 3

a: Advancement of knuckle-shaped 0.035-in. Radifocus wire. b: Both wires are closed. Antegrade intravascular ultrasound showing that the antegrade wire is in the intraplaque space and the retrograde wire is in the subintimal space. The retrograde route is dilated with a 3.0-mm balloon to enable the advancement of the Outback® Elite catheter (Cordis, Florida, USA). c: The Outback® Elite catheter is advanced retrogradely under intravascular ultrasound guidance from the antegrade direction. d: The IVUS findings of proximal SFA showed 360 degree heavy calcification. e: The IVUS findings showed 180 to 270 degree calcification. f: The IVUS findings from retrograde showed the retrograde IVUS catheter was in the subintimal space, and true lumen was relatively few calcified parts. This was the place where we tried out re-entry from retrograde using Outback® Elite catheter. g: Use of the Outback® Elite catheter. Adjustment of the L marker. h: Adjustment of the T marker. i: Successful re-entry. j: Advancement of the retrograde wire into the antegrade guiding sheath