Percutaneous aspiration thromboembolectomy (PAT) was used as an angioplastic tool to remove from arteries of the lower limbs thromboembolitic material originating from any source. PAT was performed with a custom-designed catheter/sheath system, alone or in combination with balloon dilatation and/or local lytic infusion therapy with streptokinase or urokinase. PAT completed the restoration of blood flow, thus improving the results of the preceding angioplastic interventions. Clinical improvement was high, with 93% success (42 of 45 procedures). Only one below-the-knee amputation occurred, and could not be prevented. No patient became worse because of PAT intervention. The Fogarty catheter technique remains the method of choice for removing emboli within the aorto-iliac region, but in the smaller vessels below the inguinal ligament-especially in the distal superficial femoral, popliteal, and tibial regions--in our experience PAT is superior. This has been substantiated also in studies of laboratory animals, using barium-impregnated emboli.