A, B: preoperative DSA right anterior tibial artery occlusion; C: subintimal plication to open the right anterior tibial artery; D: contrast review of the anterior tibial artery without antegrade flow, suggesting outflow tract obstruction; E, F: reverse access to the anterior tibial artery through the posterior tibial artery via the plantar arch and balloon dilation; D, H: repeat contrast review with adequate antegrade flow in the anterior tibial artery. Diabetic lower extremity vasculopathy is often characterized by multiple bilateral stenoses or occlusions of the inferior knee artery, often combined with lesions of the superior knee artery. Recanalization of the superior knee artery alone does not fundamentally resolve the symptoms of lower extremity ischemia; as an outflow tract, stenosis or occlusion of the inferior knee artery, without simultaneous recanalization, can easily be recanalized within a short period of time after recanalization of the superior knee artery. We have creatively developed an interventional technique via the plantar or dorsalis pedis artery loop, which allows patients who have failed conventional interventional treatment to obtain blood flow up to the toe, creating conditions for controlling infection, relieving ischemic symptoms, reducing the amputation level, and thus improving the long-term patency of the diseased vessels.