Can a Blocked Artery Be Opened Through the Ankle?

When the superficial femoral artery in the thigh has been completely blocked for a long time, the vessel is usually approached through the groin. In some cases the blockage cannot be crossed this way.

In such patients a vessel at the ankle (pedal artery) can be accessed so that the blockage is reached from the opposite direction, from below. This is called the retrograde transpedal approach.

In a 2021 study in Diagnostic and Interventional Radiology by Prof. Dr. Murat Canyiğit and colleagues, 25 superficial femoral artery occlusions in 23 patients treated this way between 2017 and 2019 were evaluated. Balloon angioplasty was the first option, with stenting when needed. When the common femoral artery could not be reached, a technique called 're-route' was used in 7 patients, with 100% technical success.

Over a mean follow-up of 15.3 months the one-year primary patency was 78%, and the authors concluded that the approach is safe with a low risk of complications.

This is a small, single-center experience. Not every patient is suitable; the decision is made after vascular imaging and examination. This article is general information.