{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:29:41Z","timestamp":1786544981251,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Retrograde tibial\u2010pedal access is a well\u2010established technique for managing peripheral arterial occlusive disease and its associated ischemic symptoms. While generally considered safe and effective, this method presents notable challenges due to the small caliber and, often, diseased nature of the target vessels, which can complicate entry and cannulation. As a result, multiple access attempts may be necessary, and access\u2010related complications can hinder or even prevent a successful percutaneous intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This report aims to describe a single\u2010center experience utilizing a novel access guidewire featuring a small core diameter and an articulating tip to facilitate tibial\u2010pedal access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with peripheral vascular disease in whom tibial\u2010pedal access was attempted between January 2, 2024 and September 15, 2025 were included. Real\u2010time ultrasound guidance was used in all cases. Post\u2010procedural ultrasound was performed after hemostasis was achieved with manual compression to evaluate the accessed vessel patency and rule out complications. Study outcomes were first\u2010attempt and overall guidewire insertion success, post\u2010procedural and 30\u2010day patency of the accessed vessel on ultrasound, and incidence of access site complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Records of 167 access procedures attempted in 133 patients were reviewed (left anterior tibial\u201376, right anterior tibial\u201371, right posterior tibial\u20137, left posterior tibial\u20134, left dorsalis pedis\u20131). First\u2010attempt success was 98% (154\/157 evaluable records) and all\u2010attempt success was achieved in 100% of the cases. There were no access\u2010site complications, such as occlusion, extravasation, or pseudoaneurysm. Patency was confirmed in all accessed vessels immediately following the procedure and maintained in all but one case at the 30\u2010day mark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tibial\u2010pedal access was successfully obtained in all cases, demonstrating an exceptionally high nominal first\u2010attempt success rate and no peri\u2010procedural complications. In conjunction with preserved post\u2010procedural vessel patency, these findings support the articulating\u2010tip guidewire's safety and effectiveness for its intended application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70806","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:34:23Z","timestamp":1786541663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Efficacy and Safety of Tibial\u2010Pedal Artery Access Using a Novel Articulating\u2010Tip Guidewire"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7292-9121","authenticated-orcid":false,"given":"Ashwani","family":"Sastry","sequence":"first","affiliation":[{"name":"Sunrise Vascular Center Cary North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreejit","family":"Nair","sequence":"additional","affiliation":[{"name":"Sunrise Vascular Center Cary North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"4","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1002\/ccd.1810200408","article-title":"Retrograde Recanalization of an Occluded Posterior Tibial Artery by Using a Posterior Tibial Cutdown: Two Case Reports","volume":"20","author":"Iyer S. S.","year":"1990","journal-title":"Catheterization and Cardiovascular Diagnosis"},{"issue":"3","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1177\/152660280301000330","article-title":"Percutaneous Retrograde Tibial Access in Limb Salvage","volume":"10","author":"Botti C. F.","year":"2003","journal-title":"Journal of Endovascular Therapy"},{"issue":"11","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1097\/01.RVI.0000096764.74047.21","article-title":"Simultaneous Antegrade and Retrograde Access for Subintimal Recanalization of Peripheral Arterial Occlusion","volume":"14","author":"Spinosa D. J.","year":"2003","journal-title":"Journal of Vascular and Interventional Radiology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.avsg.2023.12.105","article-title":"Retrograde Tibio\u2010Pedal Access for Endovascular Interventions for Treating Peripheral Arterial Disease","volume":"107","author":"McGuirl D.","year":"2024","journal-title":"Annals of Vascular Surgery"},{"issue":"2","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.echo.2024.12.004","article-title":"Guidelines for Performing Ultrasound\u2010Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography","volume":"38","author":"Vegas A.","year":"2025","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"4","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1007\/s00330-024-11053-3","article-title":"ESR Essentials: Arterial Vascular Access and Closure Devices\u2010Practice Recommendations by the Cardiovascular and Interventional Radiological Society of Europe","volume":"35","author":"Spiliopoulos S.","year":"2025","journal-title":"European Radiology"},{"issue":"1","key":"e_1_2_10_8_1","article-title":"Retrograde Distal Access Versus Femoral Access for Below the Knee Angioplasty","volume":"1","author":"Toledo Barros M. G.","year":"2024","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"2","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.ejvs.2020.11.020","article-title":"Technical Success and Complication Rates of Retrograde Arterial Access for Endovascular Therapy for Critical Limb Ischaemia: A Systematic Review and Meta\u2010Analysis","volume":"61","author":"Giannopoulos S.","year":"2021","journal-title":"European Journal of Vascular and Endovascular Surgery"},{"issue":"1","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.5152\/TJAR.2023.22826","article-title":"Evaluation of Success of Arterial Cannulation Employing the Dorsalis Pedis Artery Versus Posterior Tibial Artery: A Clinical Comparative Study","volume":"51","author":"Haldar R.","year":"2023","journal-title":"Turkish Journal of Anaesthesiology and Reanimation"},{"issue":"4","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4103\/sja.SJA_766_18","article-title":"Comparison of Ultrasound\u2010Guided Versus Conventional Palpatory Method of Dorsalis Pedis Artery Cannulation: A Randomized Controlled Trial","volume":"13","author":"Anand R. K.","year":"2019","journal-title":"Saudi Journal of Anaesthesia"},{"issue":"1","key":"e_1_2_10_12_1","article-title":"A Randomized Trial to Compare Ultrasound\u2010Guided Dorsalis Pedis Versus Posterior Tibial Artery Cannulation in Neurosurgical Patients","volume":"15","author":"Kaushal A.","year":"2023","journal-title":"Cureus"},{"issue":"4","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1177\/11297298231152280","article-title":"A Randomized Controlled Trial Comparing Ultrasound\u2010Guided Versus Traditional Palpatory Methods of Posterior Tibial Artery Cannulation in Adult Patients","volume":"25","author":"Sharma A.","year":"2024","journal-title":"Journal of Vascular Access"},{"issue":"2","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/11297298231219431","article-title":"Comparison of Procedural Time With Two Different Ultrasound\u2010Guided Approaches for Dorsalis Pedis Artery Cannulation in Adult Patients: A Randomized Trial","volume":"26","author":"Karan P.","year":"2025","journal-title":"Journal of Vascular Access"},{"issue":"12","key":"e_1_2_10_15_1","article-title":"Comparison of Ultrasound\u2010Guided Versus Palpatory Method of Posterior Tibial Artery Cannulation: A Prospective Randomized Controlled Study","volume":"15","author":"Eda J.","year":"2023","journal-title":"Cureus"},{"issue":"4","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1177\/11297298241276248","article-title":"Ultrasound\u2010Guided Short\u2010Axis Out\u2010of\u2010Plane Versus Long\u2010Axis In\u2010Plane Technique of Posterior Tibial Artery Cannulation in Adult Patients: The POTACUT (POsterior Tibial Artery Access With Ultrasound Trial) Randomized Trial","volume":"26","author":"Sultana S.","year":"2025","journal-title":"journal of vascular access"},{"issue":"5","key":"e_1_2_10_17_1","first-page":"482","article-title":"Factors Effecting the Success of Retrograde Tibiopedal Access and Recanalization in Infrapopliteal Artery Occlusions","volume":"31","author":"G\u00fcndo\u011fmu\u015f C. 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A.","year":"2018","journal-title":"Journal of Endovascular Therapy"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70806","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70806","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70806","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:34:28Z","timestamp":1786541668000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":29,"alternative-id":["10.1002\/ccd.70806"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70806","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"assertion":[{"value":"2025-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70806"}}