Fig. 3

Angiography of blow-the-knee arterial occlusion treatment with the “DIOL” fashion in case 2. A Control angiography of below-the-knee arterial occlusions. B, C. After antegrade wiring for posterior tibial artery (PTA) occlusion, trans-collateral approach was achieved from dorsalis pedis artery through medial plantar artery to PTA. D Retrograde-DIOL was used to realize the position of retrograde microcatheter, visualize a vessel road, and modify the CTO plaque. Microchannels (yellow arrow), the branch (orange arrow), and a tubular dissection (red arrow) were visualized. E A direct blood flow to the wounds was obtained with balloon angioplasty