Transcaval approach for endovascular aortic interventions: A systematic review

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Technology

Background:

• Traditional access routes for endovascular aortic interventions (e.g., femoral, subclavian) are not suitable for all patients.
• A novel caval-aortic access route has emerged as a potential alternative.

Purpose of the Study:

• To systematically review the outcomes of endovascular aortic interventions utilizing the caval-aortic access route.
• To assess the technical success, mortality, and complication rates associated with this approach.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched Medline, Embase, and Cochrane databases for relevant studies.
• Included 10 studies (7 retrospective, 1 prospective, 2 case reports) involving 209 patients.

Main Results:

• Overall technical success rate of 96.2% across all procedures.
• Overall mortality rate of 4.3% with a mean follow-up of 17.9 months.
• High technical success for transcaval endoleak repair (94.4%) and transcatheter aortic valve implantation (TAVI) (97.5%), with low 30-day TAVI mortality (7.6%).

Conclusions:

• The transcaval approach demonstrates encouraging safety and efficacy for endovascular aortic interventions.
• It presents a feasible alternative for carefully selected patients unsuitable for conventional access routes.
• Further research may solidify its role in managing complex aortic pathologies.