Vascular access and management of its complications.

Vascular access is needed to realize the potential of therapeutic cardiac catheterization and may consume up to 25% of the entire procedure time. Repeat interventions and multiple cardiac surgeries may result in incremental loss of access sites. The following article discusses general aspects of vascular access, imaging tools to facilitate access, the various access sites with technical approach, advantages, and specific complications. Strategies for vessel protection and management of acute bleeding and iatrogenic fistulas are presented. Also, strategies for vessel restoration after acute and chronic vascular occlusion are reviewed.