The aim of this paper is to summarize the current status of percutaneous methods for recanalizing peripheral arterial occlusions. Emphasis is placed on the role of peripheral intraarterial thrombolysis (PIAT) in the treatment of acute lower limb ischemia. Results of three prospective, randomized trials comparing PIAT with surgical revascularization are analyzed in the context of the existing, largely retrospective literature. The technique and recommendations for the application of PIAT are reviewed. Percutaneous aspiration thromboembolectomy, a technique that may be used alone or in conjunction with PIAT, is described in detail. We conclude with a brief description of various percutaneous mechanical thrombectomy devices, which may potentially see application in peripheral arterial occlusions.
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