AimTo study the feasibility and short term efficacy of retrograde subintimal angioplasty via popliteal artery access for treatment of long occlusive disease of superficial femoral artery.Methods17 patients were performed with retrograde subintimal angioplasty and endovascular stent implantation via popliteal artery access for treatment of long occlusive disease of superficial femoral artery (SFA) and proximal popliteal arteries (PA).Procedural success rate and short-term clinical efficacy were summarized.The complications together with the therapy and preventions were also analyzed.ResultsThe success rate of popliteal artery puncture was 100%.All operations were finished successfully.The mean ankle brachial index increased from 0.43±0.23 to 0.89±0.26(p<0.01) at discharge and remained improved at 6 (0.86±0.25) and 12 months (0.81±0.23）（p<0.01）.Primary patency were 94.7%（16/17）, 76.5%（13/17）at 6 months and 12 months respectively.Secondary patency was 100% at 12 months.Three (17.6%) major complications occurred, including pseudoaneurysm of PA, bleeding at the femoral puncture site and acute embolism of distal limb artery.ConclusionFailed antegrade attempts to recanalize long occlusive disease of the SFA and proximal PA can be salvaged using a retrograde popliteal access for subintimal angioplasty and endovascular stent implantation, with a low complication rate.