title: The Descending Thoracic Aorta: Forgotten Vascular Access for Endovascular Device Delivery.
abstract: Vascular access for large endovascular devices has evolved as patients have become more complicated and device indications have expanded. As the benefits of catheter-based treatments for aortic aneurysm repair and aortic valve replacement become mainstream, there is a need to address difficult vascular access by developing not only smaller-diameter devices but also creative options for vascular access. We describe direct descending thoracic aortic access during endovascular aneurysm repair, transcatheter aortic valve replacement, and redo mesenteric revascularization in three patients who did not have traditional access options.
authors.affiliation: From the Departments of *Cardiothoracic/Vascular Surgery and †Cardiology, St. Luke's Mid America Heart & Vascular Institute, Kansas City, MO USA.
authors.forename: Keith B
authors.initials: KB
authors.lastname: Allen
authors.forename: A Michael
authors.initials: AM
authors.lastname: Borkon
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Aggarwal
authors.forename: J Russell
authors.initials: JR
authors.lastname: Davis
authors.forename: Steven
authors.initials: S
authors.lastname: Laster
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Adnan K
authors.initials: AK
authors.lastname: Chhatriwalla
authors.forename: Anthony
authors.initials: A
authors.lastname: Hart
authors.forename: Suzanne J
authors.initials: SJ
authors.lastname: Baron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome