Why had Mariano already chosen a subintimal route before attempting an intraluminal crossing?
In this heavily calcified femoropopliteal case, his answer was anatomical: calcium occupied the P2–P3 lumen, with substantial plaque more proximally. He favored creating and preparing a channel around the occlusion. Miguel Montero-Baker agreed; Lucas Ferrer reflected on the time lost when the crossing strategy isn’t decided early.
Then comes a different question: once flow is restored, what tells you the wound has enough perfusion to heal—and when should you stop?
Hear the full discussion with Mariano Palena, Lucas Ferrer, and Miguel Montero-Baker of HOPE Amputation Prevention Center. Find the Mariano Palena episode on the Life of Flow channel, or search Life of Flow + Mariano Palena on Spotify.
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