ABSTRACT
Use of the vascular system itself to assist the therapist in arriving at the site of the lesion for treatment has tremendous appeal. It is simple, direct, less morbid, and leaves little external evidence of what has taken place. Much resources and development has been brought to bear in order to make standard open surgery a thing of the past and this effort has been relatively successful. As devices are miniaturized, access becomes simpler. A well-placed access site sets the operator up for success. A poorly chosen or conducted access can make a simple case complicated and possibly make a complicated case impossible. Access site issues must be considered for every case. Access-related complications are still the most common complications of endovascular intervention. An access mistake is nearly a guarantee of a complication. Consider the need for access a breach of the vascular system, a necessary evil, that ought to be minimized to the extent possible. Although a percutaneous access site is much less than a standard surgical incision, it is still what the patient notices most during the recovery process.
