Access. Choosing the best site for an initial puncture and the best path for the introduction of devices is at the core of a strategic plan for endovascular therapy. The ability to identify and successfully treat increasingly complex patterns of disease is predicated almost entirely on this key factor. To this end, this issue of Endovascular Today is devoted to access— choice of approach, technical tips, closure, critical decision making, and lessons learned. The contributors represent colleagues and experts in the field from multiple specialties, who provide us with their experience and insights related to the fundamental question: “How best should I approach this case?”

Bret N. Wiechmann, MD, shares his experience using alternative access techniques for tibial intervention and how planning a complete strategic treatment plan can lead to limb salvage and improved mortality rates.

John T. Coppola, MD, and Cezar Staniloae, MD, explore the possibility of radial access use in peripheral vascular interventions and the benefits that this approach may offer to both physicians and patients.

Kevin “Chaim” Herman, MD, looks at how to get “up and over” the challenging aortic bifurcation in order to diagnose and treat peripheral vascular disease.

In an update on vascular closure, Joshua L. Weintraub, MD; Thomas J. Ward, MD; and Edward Kim, MD, provide an overview of the current trends in technique and the wide array of devices available.

Next, Jacob Cynamon, MD, and Kevin “Chaim” Herman, MD, explain how telestrator technology can be used in lesion assessment and access, as well as for an educational resource, that may lead to better patient care and procedural outcomes.

Finally, we present the Editor's Challenge, in which I discuss a series of challenging access cases and the chosen method of treatment. For each case, I invited several panelists, including Mark W. Burket, MD; Bruce H. Gray, DO; Craig Walker, MD; and Michael Wholey, MD, MBA, to share how they would treat each case. We hope that you find this new feature informative, and we welcome your feedback on our Web site as well.

This month, we have a Techniques article in which Karthikeshwar Kasirajan, MD, shares his technique for maintaining hypogastric preservation during abdominal aortic aneurysm endografting.

We also have an interview with Sean Lyden, MD, in our Today's Practice department in which he discusses his new role as Medical Director for the Clinical Supply Chain at the Cleveland Clinic, in addition to his duties as a vascular surgeon.

In our featured interview, Hiroyoshi Yokoi, MD, discusses his practice in Japan and how global cooperation may help us achieve better patient care worldwide.

I hope that you will find this issue useful, informative, educational, and enjoyable to read. I am indebted to the experts who have provided their time and knowledge and am always open to feedback from you—the readers—regarding your thoughts about the articles, topics, and cases provided in this issue. Access away!