Cardiovascular and Interventional Radiological Society of Europe
OnlineCIRSE Academy coursesArterial Intervention - online coursesCrural revascularisation (CME) – online course

Crural revascularisation (CME) – online course


Authors: S. Spiliopoulos and M. Krokidis

Reviewers: T. Bilhim, A. M. Ierardi, W. Jaschke, C. Nice and F. Wolf

This course corresponds to chapter Peripheral arterial disease in the European Curriculum and Syllabus for IR.



Critical limb ischaemia and tissue loss are still causing significant morbidity leading to extreme healthcare costs and a dramatic decline in quality of life for the affected population. In most cases, tissue loss is related to extensive atherosclerosis of the below-the-knee arteries, and salvage revascularisation is imminently required. 

However, crural interventions, particularly for advanced atherosclerotic disease, may pose a non-negligible challenge even for experienced interventionalists. Revascularisation techniques may include conventional endoluminal and subintimal approaches according to the complexity of the treated lesions. Novel techniques such as deep vein arterialisation have also been introduced and are included in the endovascular armamentarium, broadening the spectrum of pathology that can be treated to reduce the amputation rate. Furthermore, imaging targets have shifted from merely angiographic outcomes to volumetric and functional, including sophisticated perfusion measurement tools.

The purpose of this CIRSE Academy course, focused on crural interventions, is to familiarise learners with novel materials and techniques used in complex interventions for below-the-knee arteries, to introduce perfusion technology and techniques, and to delineate the technical and imaging aspects related to deep venous arterialisation.


Learning objectives

  • Recognise the pathophysiology and anatomy of crural arteries
  • Delineate the indications and contraindications of below-the-knee endovascular revascularisation
  • Understand the difference between the various types of endovascular tools used for crural revascularisation
  • Get briefed on the use of drug eluting technology for below-the-knee interventions
  • Familiarise with the inframaleolar angioplasty approach and the Kawarada arch classification
  • Familiarise with “desert foot” management
  • Familiarise with the use of perfusion techniques for outcome assessment


Further information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter Peripheral arterial disease.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one and a half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on March 10, 2025. A non-CME accredited version of the course will remain available for two more years.

The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: March 2023