Subintimal angioplasty is such a procedure that provides a means to open a totally occluded blood vessel. This technique requires that a wire pass within the wall of a blood vessel but not within the occluded "true" lumen of the vessel. Once a wire has been re-entered into the natural, true lumen of the blood vessel, below the occlusion, a balloon is used to open this new pathway. Thus a wide open smooth passage is available for blood to pass freely into the calf and foot. The results short and intermediate terms have been very good. Certainly the risks of the procedure and complication rate are much less than bypass surgery. Limb salvage and resolution of claudication symptoms has been remarkably good in the hands of experienced vascular surgeons. Being a minimally invasive technique, subintimal angioplasty is well tolerated by most patients and requires a modest amount of equipment. The advantages of a percutaneous interventional procedure over bypass surgery are: avoidance of the complications of general anaesthesia, making an incision in an ischaemic leg and healing complications as well as less systemic stress (local anesthesia) and faster recovery and ambulation. Moreover, a re-do procedure might be more readily repeated than surgery, with the possibility of offering future surgical intervention if needed. The technique of intentional subintimal recanalisation of femoropopliteal occlusions was first described by Bolia and his associates in 1990. Their publication of long-term results in 1994, suggested that this new approach was a useful alternative to bypass surgery.