Road Mapping Guided Puncture Versus Ultrasound Guided Puncture During Retrograde Angioplasty Feasibility and Safety

Road Mapping Guided Puncture Versus Ultrasound Guided Puncture During Retrograde Angioplasty Feasibility and Safety

The study aims to compare the technical feasibility and safety of road mapping-guided versus ultrasound-guided retrograde arterial puncture in patients with (CLTI) as measured by:

• Puncture success rate
• Access-related complication rate (e.g., hematoma, vessel dissection, perforation)

Inclusion criteria: -.

1. Adults : Both male and female participants.

2. Diagnosed with critical limp threatening ischemia (CLTI):

   significant occlusions in the femoropopliteal

   o Rutherford Class 5: Non-healing wounds or ulcers

3. Failed or unable to achieve antegrade access:

   Patients requiring retrograde puncture for the procedure.

4. Planned intervention with retrograde access: Candidates for endovascular interventions, including angioplasty, stent deployment

Exclusion criteria:

• Active infection at the puncture site: Any localized infection, particularly over the ankle region , will be an exclusion.

• Severe calcification or anatomical abnormalities: Patients with excessive arterial calcification or significant anatomical distortion preventing safe retrograde puncture.