Alternative Zugangswege zur abdominellen und thorakalen Aorta bei Aortenstentbehandlungen

Stenotic, elongated, kinked and aneurysmatic aorto-iliac vessels can complicate endovascular access for introduction and deployment of aortic stent grafts. The common femoral artery cannot be used as an access vessel in these cases without further measures. Endovascular techniques can be used to achieve a sufficient diameter of the pelvic arteries. Furthermore open retroperitoneal access to the aorto-iliac arteries with or without the use of graft conduits can facilitate safe and successful placement of an aortic endograft. Rarely, supra-aortic vessels are required as an access for endograft delivery. Transapical and transseptal approaches to access the ascending aorta are further potential routes to reach the thoracic aorta.