title: [Percutaneous access for endovascular therapy of PAOD. Femoral, popliteal and pedal].
abstract: BACKGROUND
  Percutaneous interventions in patients with peripheral arterial occlusive disease (PAOD) are usually performed from an antegrade or retrograde transfemoral arterial access; however, sometimes chronic femoropopliteal and crural occlusions cannot be negotiated via this route with traditional standard methods.
  
  
  OBJECTIVE
  Description and evaluation of transfemoral, transpopliteal and transpedal vascular approaches for the treatment of advanced PAOD.
  
  
  METHODS
  A literature review of available studies on endovascular interventions with distal retrograde access was carried out.
  
  
  RESULTS
  Most complex arterial occlusions can be treated by employing modern subintimal procedures and/or additional retrograde approaches. The success rate also depends on the expertise with the appropriate technique and materials used.
  
  
  CONCLUSIONS
  The transfemoral access remains the first choice for the treatment of patients with PAOD. Additional retrograde approaches from a more distal access constitute an alternative after failure of antegrade intervention attempts.
authors.affiliation: Zentrum für Radiologie, HELIOS Klinikum Wuppertal, Klinikum der Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland. lars.kamper@helios-kliniken.de.
authors.forename: L
authors.initials: L
authors.lastname: Kamper
authors.affiliation: Zentrum für Radiologie, HELIOS Klinikum Wuppertal, Klinikum der Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Haage
mesh_terms: D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000628:therapy*; D011150:Popliteal Artery / Q000601:surgery*; D016896:Treatment Outcome
keywords: Antegrade recanalization; Arterial cannulation; Peripheral arterial occlusive disease; Retrograde approaches; Vascular access