Stent-Apposition Salvage of an Anterior Tibial Artery After Inadvertent Angioplasty Balloon Retention During CTO Revascularization

• Improved treatment for tibial level arterial occlusions makes revascularization possible.
• A balloon was retained in the target vessel and two coronary stents were deployed across the balloon.
• CTO revascularization was successful with restoration of a strong dorsalis pedis pulse.

IntroductionProgressive improvement in the ability to treat complete total occlusions in the tibial level arterial circulation have made it possible to revascularize patients with critical limb ischemia.ReportA 59 year old male presented with a complete total occlusion of his anterior tibial artery with distal reconstitution through peroneal artery collaterals. During attempted angioplasty a balloon was retained within the patent portion of the target vessel. Two 3.0 mm drug eluting coronary stents were deployed across the length of the balloon with excellent luminal preservation.DiscussionSuccessful CTO revascularization was completed and a strong dorsalis pedis artery pulse was restored following intervention.