Patients with critical limb ischaemia (CLI) often have occlusive disease of the crural arteries. Therefore attempts at treating CLI by minimally invasive means has to be directed towards recanalization of occluded crural arteries. Subintimal angioplasty of long occlusions of the crural arteries is safe and effective and is therefore an excellent alternative to reconstructive surgery in patients who are frequently elderly and frail. It is also relatively cheap when compared to bypass surgery.