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Updated: Sep 29, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
PERCUTANEOUS TRANSAXILLARY TRANSCATHETER AORTIC VALVE IMPLANTATION
J Calheiros1, A Boa2, P Braga3
1Department of Anesthesia, Unidade Local de Saúde de Matosinhos - Hospital Pedro Hispano, Matosinhos, Portugal.
Abstract:
The transaxillary (TAX) approach for transcatheter aortic valve implantation (TAVI) results in comparable short and long-term clinical results compared to the transfemoral (TF) approach. However, adequate closure of the axillary artery is the most critical issue when performing the percutaneous approach. Compared to surgical transaxillary approach, the percutaneous approach was used only in selected cases due to this closure limitation. In the present paper, we aim to demonstrate the feasibility of implanting the CoreValve Evolut Pro transcatheter heart valve via percutaneous transaxillary approach and make a literature review of procedure particularities and outcome. We describe the case of a patient with severe aortic stenosis in the presence of small calibre and severely calcified femoral arteries. A CoreValve Evolut Pro 26 was successfully implanted percutaneously through the left axillary artery. Percutaneous transaxillary transcatheter aortic valve implantation is a feasible and safe alternative in patients who have suboptimal iliofemoral vessels.
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