What is the Pedal Loop Technique

Regarded as one of the nation’s most respected and admired Interventional Radiologists, Dr. John H. Rundback specializes in complex endovascular interventions—treating the most challenging cases of critical limb ischemia and peripheral artery disease. In this article below, Dr. Rundback explains the pedal loop technique and how it treats peripheral artery disease. 

How Did the Pedal Loop Technique Originate?

The pedal loop interventional technique, also called pedal loop angioplasty or revascularization, originated from pioneering interventionalists in Europe and Asia. I’ve been doing this for many years, as my colleagues have here at American Endovascular. We have adopted this technique over the last decade, allowing us to treat patients with the most complex patterns of arterial obstructions resulting in wounds, pain, and gangrene. By utilizing the pedal loop technique, we are now the foremost and preeminent leaders in this country in treating patients with very advanced peripheral artery disease affecting the pedal loop, which might result in amputation if these procedures are not performed correctly. 

How Does the Pedal Loop Technique Help with Limb Salvage?

Pedal loop interventions can help with limb salvage and limb preservation in patients with non-healing wounds due to diabetes, chronic kidney disease, and other conditions. The pedal loop consists of arteries in the foot that are responsible for supplying blood to the toes and the heel. Patients with blockages in the pedal loop due to diabetes and other conditions can develop wounds, ulcers, or gangrene that don’t heal without restoring blood flow. While not every person needs a pedal loop intervention, there are certain individuals for whom, when the wounds don’t heal, this type of intervention is extremely important to provide the best results. Most notably, it is a procedure that not many interventionalists are comfortable performing due to the small diameter of these arteries.

What Should Patients Know about the Pedal Loop When They’re Facing an Amputation?

Pedal loop angioplasty is a technique whereby we open up the arteries at the very bottom of the blood supply into the leg. The pedal loop is actually the artery inside the foot, which supplies blood supply to the digits, where you may often get ulceration or amputation. What patients need to realize, and is extremely important, is that many doctors will open the arteries down to the knee, or even down to the ankle, but not open the arteries below the ankle within the pedal loop. This may be necessary to provide adequate blood flow for healing. Therefore, it is important if you had a prior procedure and still have non-healing wounds, that you see an expert who is able to treat disease within the pedal loop, restoring flow directly to the wounds.

Do all Specialists Perform a Pedal Loop Angioplasty?

A pedal loop angioplasty is a very specialized technique that is only performed at unique centers with expertise in treating patients with complex patterns of critical limb ischemia. A majority of doctors will limit their procedures to opening up arteries down to the level of the knee or down to the ankle instead of the foot. Often this prevents satisfactory results through the smaller arteries in the foot, which are necessary to prevent amputation, and allow for wound healing. If you have a wound in your foot that has not healed despite prior procedures, you must see an expert in treating pedal loop disease to provide the best solution and prevent limb loss.

Does the Pedal Loop Procedure Have to be Done in a Hospital Setting?

Pedal loop intervention, restoring blood flow to the arteries in the foot to potentially heal the wounds or gangrene in the toes or heel, is a specialized procedure that needs to be performed by physicians with unique expertise and the skill set and tools necessary for the best results. While the pedal loop technique is often done in hospitals, it can also be done in specialized outpatient centers, such as American Endovascular & Amputation Prevention. The more critical point is to get a physician who has the skill set and experience to perform these procedures where necessary rather than choosing this procedure based upon the site of service, being a hospital or an outpatient center. Go with the doctor first.

Request an Appointment with Dr. Rundback

At American Endovascular, Dr. John H. Rundback and our affiliated vascular specialists perform the pedal loop technique to help treat peripheral artery disease and critical limb ischemia. Please request an appointment with Dr. Rundback at our NJ Endovascular & Amputation Prevention for expert care.