Sharp Recanalization of Thrombosed Popliteal Artery Aneurysms for Claudication and Rest Pain

75 year old male with severe PAD. Prior endovascular AAA repair. Prior right leg bypass graft times 2. Both failed. Prior right leg percutaneous bypass graft 9 months ago for CLI. Worsening left leg claudication and rest pain. Patient has a thrombosed bilobed popliteal artery aneurysms. Recanalization failed using conventional techniques even with antegrade and retrograde access. Sharp recanalization with a Chiba needle was successful in establishing through and through access. Treatment with Viabahn stent grafts and kissing DES into the tibioperoneal trunk and anterior tibial artery. Resolution of rest pain and claudication.