Endovascular repair has become the treatment of choice for thoracic and abdominal aortic pathologies in the last decades, and is associated with excellent results in terms of perioperative, mid- and long-term morbidity and mortality. Access vessels play a central role in these procedures since access-related issues can increase the rates of technical failures and determine clinical complications for the patient. Therefore, accurate preoperative clinical evaluation and review of the preoperative images are mandatory. In this review, we report on the access-related issues that can be encountered during EVAR and TEVAR, and present solutions and strategies to minimize access-related adverse outcomes.
