title: Transcaval Aortic Access for Percutaneous Thoracic Aortic Aneurysm Repair: Initial Human Experience.
abstract: Transcaval aortic access has been used for deployment of transcatheter aortic valves in patients in whom conventional arterial approaches are not feasible. The present report describes its use for thoracic endovascular aortic repair (TEVAR) in a 61-year-old man with a descending thoracic aneurysm. Transcaval access was performed in lieu of a surgical iliac conduit in view of small atherosclerotic pelvic arteries. TEVAR was successfully performed, followed by intervascular tract occlusion with the use of a ventricular septal occluder. Computed tomography 2 d later demonstrated no extravasation. At 1 mo, the aneurysm was free of endoleaks, the aortocaval tract had healed, and the patient had returned to baseline functional status.
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Medical Imaging University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Andre
authors.initials: A
authors.lastname: Uflacker
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Scott
authors.initials: S
authors.lastname: Lim
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Michael
authors.initials: M
authors.lastname: Ragosta
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Medical Imaging University of Virginia, 1215 Lee St., Charlottesville, VA 22908. Electronic address: ziv2@mac.com.
authors.forename: Ziv J
authors.initials: ZJ
authors.lastname: Haskal
authors.affiliation: Division of Intramural Research, Cardiovascular and Pulmonary Branch (R.J.L.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lederman
authors.affiliation: Division of Vascular Surgery, Department of Surgery (J.K., G.U.) University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: John
authors.initials: J
authors.lastname: Kern
authors.affiliation: Division of Vascular Surgery, Department of Surgery (J.K., G.U.) University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Upchurch
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Medical Imaging University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: Timothy
authors.initials: T
authors.lastname: Huber
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Medical Imaging University of Virginia, 1215 Lee St., Charlottesville, VA 22908.
authors.forename: John F
authors.initials: JF
authors.lastname: Angle
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Virginia, 1215 Lee St., Charlottesville, VA 22908;
authors.forename: Gorav
authors.initials: G
authors.lastname: Ailawadi
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019919:Prosthesis Implantation / Q000379:methods*; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*