Internal Endoconduit-Assisted Transfemoral TAVR in a Patient With Severely Diseased Iliofemoral Anatomy.

Authors

Shinya Minami, Yasuhiro Ichibori, Satoshi Nakawatase, Naoki Mori, Osamu Iida

Published in

JACC. Case reports. Pages 109009. Jun 27, 2026. Epub Jun 27, 2026.

Abstract

The internal endoconduit technique may facilitate transfemoral transcatheter aortic valve replacement (TAVR) in complex vascular anatomies.
A 71-year-old woman with symptomatic severe aortic stenosis and diffusely narrowed iliac and femoral arteries was considered unsuitable for transfemoral access. A staged, internal endoconduit-assisted transfemoral TAVR was performed. First, overlapping VIABAHN covered stent grafts were deployed to create an arterial conduit in iliofemoral arteries. Two weeks later, a 26-mm Evolut FX valve was successfully implanted. Hemostasis was successfully achieved using Perclose ProStyle sutures and an additional stent graft.
The internal endoconduit technique in TAVR has not been previously described in detail. A preprocedural ex vivo simulation was performed to devise an optimal strategy, enabling the safe execution.
The internal endoconduit technique represents a viable alternative for overcoming hostile vascular anatomy during transfemoral TAVR; nonetheless, important considerations remain, such as the interval before TAVR, the graft puncture site, and sheath selection.

PMID:
42363929
Bibliographic data and abstract were imported from PubMed on 27 Jun 2026.

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