Endovascular Repair of Thoracic Aortic Aneurysm Using Transcaval Aortic Access Technique

Repair of thoracic aortic aneurysms has evolved in recent history. Open surgical intervention has largely been replaced with endovascular intervention. However, there are anatomic limitations to thoracic endovascular aneurysm repair. In patients with peripheral vascular disease or vessel tortuosity, it becomes dangerous to attempt percutaneous access or graft deployment for fear of severe complications, such as dissection or occlusion. We describe a technique whereby access to the aorta is obtained through the inferior vena cava, allowing the thoracic aneurysm to be repaired endovascularly.