Related Experiment Video
Updated: May 3, 2026
A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Transcarotid Artery Approach for Endovascular Aortic Repair in Treating Complex Descending Thoracic Aortic
Haofan Shi1, Xingyou Guo1,2, Chengkai Su1
1Department of Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Insights
For patients with aortoiliac artery occlusion, endovascular aortic repair via the carotid artery approach offers a viable alternative when the femoral artery route is not feasible. This case study highlights its potential for complex aortic repair cases.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Aortic Disease Management
Background:
- Endovascular aortic repair (EVAR) is preferred over open surgery for aortic diseases due to lower perioperative risks.
- The femoral artery is the standard access route for EVAR.
- Aortoiliac artery occlusion presents challenges for conventional femoral access, necessitating alternative strategies.
Purpose of the Study:
- To present a case of EVAR using a transcarotid artery approach in a patient with aortoiliac occlusion.
- To evaluate the feasibility and safety of the carotid artery as an alternative access route for EVAR.
Main Methods:
- A case study detailing EVAR via the left carotid artery in a patient with aortoiliac occlusion and a prosthetic graft pseudoaneurysm.
- Review of existing literature on transcarotid artery approach for EVAR.
Main Results:
- Successful EVAR was performed using the left carotid artery access in a complex case.
- The procedure was associated with minimal complications in this single-case study.
Conclusions:
- The transcarotid artery approach may be a viable alternative for EVAR in select patients with aortoiliac occlusion when femoral access is not possible.
- Further research, including randomized controlled trials, is required to establish the safety and efficacy across diverse patient populations.
Abstract:
BackgroundEndovascular aortic repair has emerged as the preferred treatment modality over open surgery for aortic diseases, primarily because of its association with lower perioperative morbidity and mortality rates. Current diagnostic and treatment guidelines generally advocate for endovascular aortic repair in most cases, with the femoral artery serving as the conventional access route. However, this approach may not be feasible for all patients, particularly those with aortoiliac artery occlusion, necessitating alternative access strategies.Case SummaryThis paper presents a complex case study of a patient with aortoiliac artery occlusion who underwent endovascular aortic repair via the left carotid artery approach for a pseudoaneurysm at the anastomotic site of a descending aortic prosthetic graft. This case underscores the potential value of utilizing the carotid artery as an alternative access route in anatomically challenging situations.ConclusionResearch on transcarotid artery approach endovascular aortic repair is limited and predominantly consists of case reports, with a notable absence of randomized controlled trials. This case report suggests that endovascular aortic repair via the carotid artery approach may be a viable alternative for selecting patient groups when the conventional femoral artery approach is not feasible. While our single case demonstrated successful management with minimal complications, larger studies are needed to fully establish the safety profile and determine if perioperative complications and mortality rates are indeed manageable across diverse patient populations.Clinical ImpactThis study provides valuable insights into the feasibility of the carotid artery as an alternative access route for endovascular aortic repair in patients with aortoiliac artery occlusion. It offers clinicians a potential strategy for cases where the conventional femoral artery route is not feasible. The findings presented herein aim to demonstrate the practicality and relative safety of utilizing the carotid artery for endovascular procedures in anatomically challenging scenarios, contributing to the broader understanding of access alternatives in aortic repair interventions.
