[Peripheral arterial angioplasty: value of the popliteal approach. Apropos of 30 cases].

The percutaneous common femoral arterial approach is usually used for endovascular management of lower limb arterial disease. This approach is sometimes impracticable because the femoral artery is the site of severe calcific atheromatous lesions which prevent arterial puncture or, when the superficial femoral lesions are ostial or proximal, make it impossible to position the introducer and advance the guide wire. The popliteal artery then becomes very useful for treating these lesions by a retrograde approach. Similarly, superficial femoral lesions which cannot be successfully dilated by the anterograde femoral approach may justify retrograde catheterisation via the popliteal artery. Between May 1988 and August 1991, the authors used the retrograde popliteal approach in 30 cases. They obtained 24 successes, 12 of which were associated with the implantation of an endoprosthesis. There was 1 complication at the puncture site a popliteal arteriovenous fistula was created but was treated successfully by surgery.