Retrospective, multicenter review between January 2015 and December 2019. A total of 272 patients were treated for symptomatic aortic arch occlusive disease. Successful revascularization rate was significantly higher in the stenotic group (94%) compared to the occlusive group (86%). Dual access was used significantly more often to treat occlusions (60%) than stenoses (11%). The major adverse event rate was 9% in dual access cases vs 5% in single access (P = .15). The safest access was ultrasound-guided distal radial artery puncture. Percutaneous revascularization of proximal upper limb arteries is safe and effective. Dual access can be applied to increase treatment efficacy without significantly compromising safety.