October 2, 2025Open Access

Emergency Direct Transabdominal Aortic Access for TEVAR Following Spasm-Induced Iliac Access Failure: Technical Considerations and Clinical Decision-Making

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Case report highlights emergency transabdominal aortic access for TEVAR, indicating iliac artery spasm as a significant barrier.

Emergency direct transabdominal aortic access effectively recovered access failure caused by iliac artery spasm.
A 58-year-old woman underwent TEVAR after bilateral femoral access failed due to severe iliac artery spasm.
The procedure involved a midline laparotomy to insert a 21-French sheath and deploy a stent graft successfully.
Iliac artery spasm represents a crucial yet often overlooked challenge in endovascular aortic repair procedures.

Yu et al. (2025) studied this question.

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