A 5-F needle-sheath catheter delivery system allows translumbar introduction and interchange of 4-F-catheters with various lengths and shapes. The system was used in 236 patients. In 227 cases, a pigtail catheter was introduced for outflow studies of the lower extremities or visualization of the aortic arch. In 9 cases a selective catheter (sidewinder, headhunter, cobra) for angiography of a total of 19 vessels (carotid arteries, visceral arteries, renal arteries) was used. No major complications related to aortic puncture or catheter manipulation occured, no relevant retroperitoneal hematomas were observed. The 5-F needle-sheath system is a safe and simple alternative to the more precarious transbrachial technique.