Distal Anterior Tibial after Failed PTA

CLI patient (Rutherford 5) with foot ulceration. Diagnostic angiogram shows near-occlusion of distal AT. 2.5mm PTA of AT and dorsalis pedia attempted with near-immediate recoil and unsatisfactory result. 2.5mm x 40mm Shockwave IVL introduced into distal AT. Post-IVL angiogram shows resolution of stenosis with good distal flow into dorsalis pedis and no complications.