ABSTRACT
Balloon angioplasty and stents provide options that expand the scope of patients who are eligible for treatment of infrainguinal occlusive disease. Endovascular infrainguinal techniques are most useful in patients who are poor candidates for open surgery and in those with focal, short segment disease. The long-term results of femoropopliteal angioplasty are not generally as good as those for surgery and vary signi Qcantly based upon the severity and extent of the occlusive disease. This is likely to change soon if drug-eluting stents improve long-term results. The current practice of infrainguinal intervention may di Rer substantially from institution to institution based upon the level of enthusiasm for these techniques. Infrainguinal arteries may be approached through an ipsilateral antegrade femoral puncture or a contralateral femoral puncture followed by passage of the catheter over the aortic bifurcation. Chapter 2 shows how to perform an antegrade puncture. Chapter 6 provides methods for antegrade passage into the ipsilateral super Qcial femoral artery (SFA) and also crossing the aortic bifurcation. Chapter 8 details techniques for including the lower extremity in an arteriographic runo R study and for performing femoral arteriography and selective lower-extremity and pedal arteriography.
