Transfemoral Access Techniques in Thoracic Aortic Endografting

Abstract

The most common percutaneous access sites for thoracic endografting are the femoral and brachial arteries. When choosing which site to access the vascular tree, one must consider not only the intended procedure but also the size of the sheath and distance to the pathology. The goal for percutaneous access is to create the smallest incision, which provides safe and effective entry, without creating vascular trauma. Sheaths up to 12 Fr (4.0 mm) can be safely placed percutaneously. Larger sheaths require a cut down to ensure vascular hemostasis and minimize traumatic injury. If the physician is not adaptive to utilizing alternative access sites, then the procedure will be compromised.