Retrograde Crossing through the Pedal Arch for Totally Occluded Tibial Artery

Critical limb ischemia is characterized by atherosclerotic disorder of the crural arteries. The occlusion of dorsalis pedis and paramalleolar posterior tibial arteries is a rare atherosclerotic pattern in the crural arteries. We present a successful case of retrograde posterior tibial artery crossing through the pedal arch after antegrade recanalization of occluded anterior tibial and dorsalis pedis arteries, leading to the achievement of complete infrapopliteal recanalization and wound healing.