Vascular access in critical limb ischemia

Won Yu Kang, Umberto Campia, Hideaki Ota, Romain J. Didier, Smita I. Negi, Sarkis Kiramijyan, Edward Koifman, Nevin C. Baker, Marco A. Magalhaes, Michael J. Lipinski, Ricardo O. Escarcega, Rebecca Torguson, Ron Waksman, Nelson L. Bernardo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each.

Original languageEnglish
Pages (from-to)190-198
Number of pages9
JournalCardiovascular Revascularization Medicine
Issue number3
StatePublished - 1 Apr 2016
Externally publishedYes


  • Amputation
  • Antegrade access
  • Critical limb ischemia
  • Limb salvage
  • Metatarsal
  • Pedal
  • Retrograde access
  • Vascular access


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