Abstract
Aortic pathologies such as dissection, aneurysm, or blunt aortic injury have historically
been treated via open surgical repair; however, the advent of endovascular stent graft
technology has allowed for endovascular aortic repair in more and more patients. With
improvements in stent graft technology and delivery systems, more patients are now
candidates for endovascular aortic repair; however, many will require large-bore transfemoral
arterial access. Percutaneous transfemoral arterial access includes the introduction
of a large-bore sheath directly into the iliofemoral arterial system for the deployment
of aortic stent grafts. Advancements in percutaneous arterial closure and reductions
in device delivery profiles have further refined this technique; however, careful
preprocedural planning and technical precision are required to minimize complications.
This article covers the fundamentals of large-bore transfemoral arterial access as
well as technical pearls for successful outcomes.
Keywords
endograft - access - interventional radiology - closure device - femoral
