Peripheral Facilitated Antegrade Steering Technique in Chronic Total Occlusions

Inclusion Criteria: * suitable candidate for non-emergent, peripheral angioplasty * documented de-novo or restenotic peripheral CTO lesion with TIMI 0 flow for at least 90 days and satisfactory distal vessel visualization (collateral supply) * limb ischemia or claudication, Rutherford class I-III (grade 1-5) caused by the occluded artery Exclusion Criteria: * intolerance to aspirin or a neutropenic response to Ticlopidine or Clopidogrel * appearance of thrombus or intraluminal filling defects * peripheral intervention in the target limb within two weeks of the procedure * renal insufficiency (serum creatinine of \> 2.3 mg/dl) * contraindication to a peripheral artery intervention * participation in another investigational protocol