[Percutaneous access for endovascular therapy of PAOD. Femoral, popliteal and pedal].

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.

OBJECTIVES: Description and evaluation of transfemoral, transpopliteal and transpedal vascular approaches for the treatment of advanced PAOD.

MATERIAL AND 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.

CONCLUSION: 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.