Axillary Artery Access as an Adjunct for Complex Endovascular Aortic Repair

Upper extremity arterial access is required to snorkel one or more of the visceral vessels during complex endovascular pararenal aortic aneurysm repair. There are several techniques of arm access that can be used. Brachial access is appropriate when a single visceral vessel must be cannulated, and by utilizing the conduit/sheath combination presented here, it is possible to safely approach multiple visceral vessels from an axillary access. Further evolution of this technique will expand our ability to treat complex paravisceral aneurysms.