Use of Stingray re-entry system in treatment of complex tibial artery occlusive disease.

One of the mechanisms of technical failure in the treatment of tibial artery occlusive disease includes an inability to re-enter the true lumen of the tibial vessel distal to the occlusion following tracking of the interventional wire into the subintimal space. We report the first case using a coronary 0.014″ re-entry system (Stingray Chronic Total Occlusions Re-entry System, BridgePoint Medical) in the treatment of a complex tibial artery occlusion where the antegrade approach initially failed due to this mechanism. The re-entry system allowed completion of antegrade recanalization of the occlusion and represents an important addition to the interventional armamentarium for the treatment of complex tibial artery disease.