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Updated: May 24, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Direct aortic transcatheter aortic valve implantation: a feasible approach for patients with severe peripheral
Eduardo Alegría-Barrero1, Pak Hei Chan, Carlo Di Mario
1Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK. eduar.alegria@gmail.com
Abstract:
Aortic stenosis is a prevalent disease with poor prognosis if left untreated. Transcatheter aortic valve implantation (TAVI) is an emerging treatment for patients at high risk for surgery. We describe a patient with no suitable peripheral access due to peripheral vascular disease (PVD) for TAVI. Direct aortic approach via an 18-Fr sheath inserted into the ascending aorta was successfully performed with a 29-mm CoreValve implanted. Direct aortic approach is feasible for TAVI in patients with severe PVD without good peripheral access.
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