Fig. 1

Case #1 (a) Retrograde angiography via the right peroneal artery (thick white arrow) demonstrating the tibioperoneal (TP) trunk into the proximal peroneal artery CTO (thin white arrows) with an extensive network of collaterals and vague reconstitution of the native popliteal artery through retrograde filling (black arrow). b Antegrade angiogram re-demonstrating the CTO with zero vessel runoff and an occluded proximal ATA (black arrow). Note again the retrograde catheter in the peroneal artery (white arrow). c The Outback re-entry device entering the true lumen of the distal popliteal artery (white arrow). d Balloon angioplasty via pedal artery access. e Post-intervention angiogram showing successful recanalization through the TP trunk and peroneal artery. f Post-intervention angiogram of the peroneal artery access site illustrating excellent flow without vessel injury