The carotid artery as alternative access for endoluminal aortic aneurysm repair

Endograft treatment of aortic aneurysms has become a common procedure in ma ny centers. However, not all patients are candidates for this new technolog y, because of their vascular anatomy and device limitations. One common pro blem is iliofemoral occlusive disease, which when present, even in a modera te degree, may preclude introduction of the large-diameter delivery devices currently in use. We present a case of a high-risk male patient with a tho racic aortic aneurysm and severe occlusive disease of the iliac arteries. A n alternative approach fur device delivery through the carotid artery was u sed and the procedure was successful with no neurologic complications. We r ecommend this technique for highly selected patients with an aneurysm who c an undergo tube endograft repair without feasible access through the iliac or femoral arteries.