Related Experiment Video
Updated: Mar 16, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Modified Single-Puncture Technique for Transcatheter Aortic Valve Implantation in Patients without Peripheral
Gianluca Lucchese1, Nicholas Montarello1, Vinayak Bapat1
1Guy's and Saint Thomas' NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.
Abstract:
Transcatheter aortic valve implantation (TAVI) is now routinely performed to treat inoperable and high-risk patients with severe aortic stenosis (AS). Transapical or transaortic approaches are alternative routes used when peripheral accesses are unsuitable.Correct placement of the device is achieved with the help of an angiography performed with a pigtail catheter to identify the deployment view. However, in patients with severe vascular disease, placement of a pigtail catheter may not be possible.We report a modified single-puncture technique, whereby a single access point is used to perform both angiography and TAVI by using visible calcification landmarks as reference points.

