Advanced Endovascular Techniques for Limb Salvage

As the number of patients with CLTI is increasing, new endovascular revascularization strategies beyond the mostly plain balloon-based technologies may provide new so-lutions. Coupled with drug-coated devices, IVL, and atherectomy can be useful in the management of long-segment, highly calcified femoropopliteal lesions. An array of 0.014-inch platform devices including serrated balloons, IVL, and dissection stents have been developed specifically for the tibial segment. Deep and superficial vein arterialization can be performed through a percutaneous, open surgical, or hybrid ap-proaches in no-option CLTI patients with encouraging results for limb salvage.