Are leg arteries ever "too small to treat"? Around the world, many patients with Peripheral Artery Disease (PAD), especially those with below-the-knee and small vessel disease, are told their arteries are "too small" or "too distal" for intervention. In this episode of The Heart of Innovation, hosts Kym McNicholas and Dr. John Phillips interview Dr. Naoki Hayakawa, Chief and Director of Endovascular Therapy at Asahi General Hospital in Japan.Dr. Hayakawa is internationally recognized for tackling the most complex chronic total occlusions (CTOs), including small-caliber below-the-knee vessels that others may consider untreatable. He has served as a live demonstration operator at major international meetings including JET, CCT Peripheral, Kokura Live, and Peripheral CTO Seminars, and has published extensively on: • IVUS-guided wiring techniques • Below-the-knee chronic total occlusions • Drug-coated balloon therapy • Transradial approaches for complex PAD • Advanced re-entry and retrograde access techniques His work challenges outdated assumptions about what is and isn't possible in limb salvage.In this conversation, Dr. Hayakawa sets the record straight on: • What can truly be treated in small vessel PAD • When vessels are actually too small • The importance of imaging and IVUS guidance • Why patients must seek experienced operators for complex disease • What global standards of care should look like If you or someone you love has been told "nothing more can be done," this episode is essential viewing. - Concerned about leg circulation or told your vessels are too small?Call the Leg Saver Hotline: 1-833-PAD-LEGSBecause "too small to treat" should never be the final answer without expert evaluation. Subscribe to The Heart of Innovation for global leaders in vascular innovation, limb salvage, and PAD care. #PeripheralArteryDisease#PAD#LimbSalvage#BelowTheKnee#ChronicTotalOcclusion#EndovascularTherapy#IVUS#CriticalLimbIschemia