Feasibility and safety of ipsilateral antegrade 4-French access in the endovascular treatment of peripheral artery disease

Traditionally, contralateral retrograde or ipsilateral antegrade 6 F access has been the predominant approach for endovascular interventions in peripheral artery disease (PAD). This study explores the feasibility and safety of using ipsilateral antegrade 4 F access as an alternative in the endovascular treatment of PAD. The objective of this study is to evaluate the technical success and complication rates associated with ipsilateral antegrade 4 F access in PAD patients undergoing endovascular procedures. This retrospective study included 113 PAD patients (77 males and 36 females) who underwent endovascular treatment using the ipsilateral antegrade 4 F technique between February 2020 and July 2023. Data on patient demographics, procedural characteristics, technical success, and periprocedural complications were collected and analyzed. Complete technical success was achieved in 106 cases (93.8%), partial technical success in 6 cases (5.3%), and technical failure in 1 case (0.9%). Complications occurred in 4 patients (3.5%), while 109 patients (96.5%) had no complications. Ipsilateral antegrade 4 F access demonstrates high technical success and low complication rates, suggesting it is a viable and safe alternative for endovascular treatment of PAD. However, further prospective studies are recommended to validate these findings and to assess the long-term safety and effectiveness of this technique.