ABSTRACT
Introduction In endovascular treatment of peripheral arterial disease, the antegrade or retrograde femoral approach is the most often used access.
Lesions at the femoral bifurcation prevent guidewires and introducers from being placed. This leads to the use of other approaches such as the brachial, radial, contralateral, or popliteal accesses. Described herein are the antegrade and retrograde popliteal approaches, as well as the present authors’ experiences, so defining the current technique and its indications.1-9
Techniques Retrograde percutaneous popliteal approach The popliteal artery, together with the sciatic nerve and the popliteal vein, goes upward along the diagonal of the popliteal triangle. The superficial location of the popliteal artery allows retrograde puncture, which is usually performed just above the joint. The patient is preferably in the ventral decubitus position but may alternatively be in the lateral decubitus position. The procedure is usually performed under local anesthesia and complemented by intravenous sedation. General anesthesia, which may still be performed, is rarely required.
