title: Technical endovascular highlights for crossing the difficult aortic bifurcation.
abstract: Effective endovascular treatment requires successful vascular access to reach the targeted lesion. When the targeted lesion is infrainguinal in location, the vascular access options include the ipsilateral antegrade femoral approach, the contralateral retrograde femoral approach, or the transbrachial approach. The contralateral retrograde femoral route remains the most commonly used approach but may be challenging, particularly in the settings of a scarred groin or a difficult aortic bifurcation. The purpose of this article is to provide technical tips for the challenges encountered in obtaining contralateral femoral access for peripheral interventions with a difficult aortic bifurcation.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of California, San Francisco, Calif., USA.
authors.forename: S Marlene
authors.initials: SM
authors.lastname: Grenon
authors.forename: Linda M
authors.initials: LM
authors.lastname: Reilly
authors.forename: Ventakesh G
authors.initials: VG
authors.lastname: Ramaiah
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D057510:Endovascular Procedures / Q000379:methods*; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D015641:Radiography, Interventional; D016896:Treatment Outcome