Endovascular abdominal aortic aneurysm repair to facilitate access for transcatheter aortic valve implantation

Transcatheter aortic valve insertion is an accepted treatment for select patients at high-risk for standard aortic valve insertion. Constraints imposed by the Food and Drug Administration, Centers for Medicare and Medicaid Services, and the PARTNER Trial Executive Committee require a transfemoral approach in certain patients. The presence of aortoiliac aneurysms, occlusive disease, and excessive vessel tortuosity may create difficulties for safe transfemoral access. We report a case in which the limitation of severe iliac artery occlusive disease was overcome by placement of an abdominal aortic endovascular graft that subsequently allowed successful transfemoral access and transcatheter aortic valve implantation.