Key result
Transcaval access enables successful total transfemoral TAMBE repair in 100% of hostile anatomy cases.
Why the study?
Patients with thoracoabdominal aortic aneurysms and hostile iliofemoral access anatomy require alternative percutaneous routes for delivering large endovascular devices such as the Gore Excluder Thoracoabdominal Multibranch Endoprosthesis (TAMBE).
Case Report (n=2)
Answers are grounded in this paper and cite their sources.
Transcaval access is a feasible alternative approach enabling total transfemoral branched endovascular repair of thoracoabdominal aortic aneurysms in patients with hostile iliofemoral access.
Transcaval access is a means of creating a common channel from the Inferior Vena Cava (IVC), across the retroperitoneal space, and into the abdominal aorta for delivery of large devices entirely percutaneously. It has been successfully applied to procedures in interventional cardiology, pediatric cardiology, and vascular surgery for the delivery of aortic valves, thoracic endovascular aortic repairs (TEVAR), and mechanical cardiac support (Impella, ECMO, IABP). Here we describe two patients with hostile access anatomy in which transcaval access allowed for successful total transfemoral repair of thoracoabdominal aortic aneurysms with Gore Excluder Thoracoabdominal Multibranch Endoprosthesis (TAMBE).
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Cralle et al. (2026) conducted a case report in Thoracoabdominal aortic aneurysms with iliofemoral occlusive disease and hostile access anatomy (n=2). Transcaval access for total transfemoral repair with Gore Excluder Thoracoabdominal Multibranch Endoprosthesis (TAMBE) was evaluated on Successful total transfemoral repair of thoracoabdominal aortic aneurysms. Transcaval access enabled successful total transfemoral thoracoabdominal aortic aneurysm repair with TAMBE in 2 of 2 (100%) patients with hostile access anatomy.
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