Key result
Transcaval access for TEVAR shows stable aortic repair without access-site complications at 6 years.
Why the study?
TEVAR requires sufficiently large femoral access for endograft delivery, prompting evaluation of long-term outcomes following transcaval access.
Case Report (n=1)
No
Transcaval access for TEVAR appears to be a safe and durable alternative to traditional femoral artery access at 6-year follow-up in a highly-select patient.
Supports potential durability of transcaval TEVAR access; hypothesis-generating and should not change practice.
Thoracic endovascular aortic repair (TEVAR) has reduced the morbidity and mortality associated with the treatment of thoracic aortic pathologies. However, TEVAR's use is often predicated on sufficiently large femoral access for the delivery of the endograft device. Transcaval access, or the delivery of endovascular device via the vena cava before crossing into the aorta, has been used successfully for the deployment of transcatheter aortic valves. Our institution previously reported on a case of TEVAR using transcaval access. We now report on the long-term follow-up outcome of this case. At 6 years post-surgery, computed tomography angiography (CTA) indicates stable aortic repair without any concerning findings associated with the site of transcaval access into the aorta. The patient is clinically without signs of lower extremity vascular or cardiopulmonary compromise. Overall, transcaval access for TEVAR is a promising alternative to traditional femoral artery access in highly-select patients with the appropriate anatomical and pathological indications.
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Le et al. (2022) conducted a case report in Thoracic aortic pathology requiring TEVAR (n=1). Transcaval access for TEVAR was evaluated on Long-term follow-up outcome (stable aortic repair and clinical signs). At 6 years post-surgery, transcaval access for TEVAR demonstrated stable aortic repair without concerning findings at the access site or signs of vascular or cardiopulmonary compromise.
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