Fig. 4
From: Targeted tibio-peroneal re-entry during subintimal revascularization using the Outback® catheter
a and b: initial runoff prior to revascularization showing a chronic occlusion of the popliteal artery, the tibio-peroneal trunc and the proximal segment of the peroneal artery; well preserved anterior tibial artery as primary target vessel for recanalization; retrograde recanalization not possible dur to extensive wounds and inflammation; c: positioning of the Outback® catheter at the ostium of the anterior tibial artery with the 0.014″ wire already extending into the anterior tibial artery, the distal course being better visible due to movement artefacts; d: balloon angioplasty after successful re-entry and placement of a self-expandable stent (Optimed sinus SuperFlex-418®); e: result after angioplasty of the anterior tibial artery and now probing of the tibio-peroneal trunc and peroneal artery through the meshes of the placed stent; f: balloon angioplasty of the tibio-peroneal trunc and the proximal peroneal artery; g and h: final result with a restored two vessel runoff, however, with a dissection of the tibio-peroneal trunc not being flow limiting at the time of angiography, but certainly with a higher risk of re-occlusion