Access Approach Research Articles

Recent experience with calcium phosphate cement cranioplasty after lateral supraorbital keyhole approach to the anterior cranial fossa.

Through an eyebrow incision, the lateral supraorbital (LSO) keyhole approach provides access to various lesions in the anterior cranial fossa and affords many of the advantages of minimal access and minimally invasive surgery. The LSO approach and other minimal access approaches including various endonasal approaches to the anterior cranial fossa, however, have been associated with nonnegligible rates of CSF leaks postoperatively. The authors report their recent experience using calcium phosphate cement cranioplasty as a method of preventing CSF leakage after LSO keyhole craniectomy. A retrospective medical records review was performed for 9 consecutive patients undergoing operations by the senior authors using the LSO keyhole approach with skull defect repair using calcium phosphate cement cranioplasty alone between 2022 and 2024. Review of the medical records included clinic notes, imaging studies, and operative notes as well as details regarding the length of hospital stay, complications, and rate of tumor recurrence. Eight of 9 patients underwent resection of meningiomas, while 1 underwent resection of a cavernous malformation. The cohort consisted of 7 females (78%) and 2 males (22%) with a mean age of 55.2 years. The mean tumor volume among the 8 meningiomas was 18.09 cm3, and peritumoral edema was present in 8 of the 9 cases (89%). Gross-total resection was achieved in 7 of 8 meningioma cases (87.5%). Among the 9 patients, the mean length of hospital stay was 2.4 days. Two patients (22%) experienced complications. No patients experienced a CSF leak postoperatively. At a mean follow-up of 13.8 months, 1 patient (12.5%) experienced tumor recurrence. Based on this and prior experience, the use of calcium phosphate cement cranioplasty alone following an LSO keyhole approach to the anterior cranial fossa is a safe alternative to traditional closure techniques, which rely on replacement of bone flap with plates and screws, and it might reduce the rate of postoperative CSF leakage. Larger studies are required to confirm these findings.

Use of the mini-forceps traction-assisted cannulation technique when standard ERCP methods fail: Single-center retrospective study

AbstractThere are few salvage techniques for achieving biliary cannulation when no duct can be accessed.We retrospectively reviewed 10 consecutive cases in which the mini-forceps traction-assisted cannulation technique (MFTAC) was used after failure of any duct access during endoscopic retrograde cholangiopancreatography (ERCP). Outcomes included technical success, use of adjunct techniques; time to biliary access; and adverse events (AEs).Most patients had a native papilla (n = 9) of peri-diverticular location (n = 5) and a benign indication (n = 6). Standard cannulation was unsuccessful over 8:23 mm:ss (interquartile range [IQR] 6:04–19:43). MFTAC had 100% technical success, achieved biliary access after 17:38 mm:ss (IQR 8:52–20:31), and had a 10% incidence of AEs (post-ERCP pancreatitis). MFTAC was sufficient to allow biliary cannulation in three cases and allowed pancreatic duct access in seven cases, which then allowed biliary cannulation with double-wire technique (5/10) and transpancreatic septotomy (2/10).MFTAC is a feasible salvage approach for biliary access when standard cannulation methods fail.

Approaches to surgical access for impacted tooth removal in the mandible: clinical case reports

Relevance. Delayed eruption of mandibular canines and premolars is a frequent concern in pediatric dentistry, commonly linked to tooth retention or impaction. Several treatment strategies are available to address this issue, including surgical-orthodontic repositioning into the dental arch or extraction of the affected teeth. Given the anatomical positioning of impacted teeth in the mandible, surgical procedures are often performed via a vestibular approach, which can lead to substantial bone defects and an elevated risk of microtrauma to the vascular-nerve bundle.Description of clinical case. In the first case, during the removal of the impacted tooth 3.3 and a follicular cyst in the left mandibular region, a portable nasopharyngolaryngoscope was used to ensure sufficient visibility. The surgical intervention involved a selective method of minimally invasive osteotomy performed with a surgical hand-piece, which allowed for a reduction in the size of the bony wound and the prevention of trauma to the vascular- nerve bundle. In the second case, during the removal of the impacted tooth 3.5, a selective method of minimally invasive osteotomy was also applied, utilizing a dual vestibular approach. This technique reduced the size of the bone defect and minimized the risk of injury to the mental nerve.Conclusion. When a tooth is positioned in proximity to the mandibular canal or mental foramen, it is essential to adjust the surgical access approach accordingly. This article provides an overview of clinical cases involving the removal of impacted teeth, highlighting the application of different surgical techniques.

Transhepatic venous access for catheter ablation of right and left side atrial arrhythmias in adults: challenges and outcomes.

Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5%. Three patients with limited venous access were referred for ablation between 2018 and 2021. The percutaneous transhepatic access approach provided good support for the EP study, electro-anatomical mapping, and effective radiofrequency ablation of right and left-side arrhythmias. No significant complications were documented, and all patients were discharged within 48 hours of the procedure. At follow-up, all patients had excellent arrhythmia control without significant adverse events. Percutaneous transhepatic access is a feasible and safe alternative to femoral venous access for EP procedures in adult patients with limited venous access.

A novel “lateral approach short axis in-plane” technique vs. conventional “short-axis out-of-plane approach” for ultrasound-guided internal jugular vein access: a prospective randomized non-inferiority trial

BackgroundThe cannulation of the internal jugular vein (IJV) is a frequent procedure in critically ill patients. According to the guidelines, real-time ultrasound navigation is recommended. Traditional techniques pose several disadvantages, such as suboptimal needle visualization. Therefore, this non-inferiority trial aimed to describe the novel approach and compare the novel lateral in-plane short-axis approach for IJV access with the conventional short-axis out-of-plane approach.ObjectivesThe primary objective of the trial was to prove that the first attempt success rate in the novel technique is non-inferior to the conventional technique. The secondary objectives were to demonstrate that the complication rate and the functional duration of the catheter in the novel technique are not inferior to those in the conventional technique.MethodsPatients eligible for IJV cannulation were randomly assigned to either the novel technique (Group A) or the conventional one (Group B). The procedure duration, success rate and the number of attempts required were documented. The functionality of the catheter and complications were monitored from insertion until the catheter removal. Standard descriptive statistical methods were employed for the analysis.ResultsA total of 200 subjects were equally divided between Group A and Group B. For the primary outcome, there was no significant difference in first attempt success rate (Group A: 79, Group B: 77, p = 0.434). Secondary outcomes, including complications and catheter functional time, did not differ significantly between the groups. However, the novel technique demonstrated a significantly faster procedure time (Group A: 315 s, Group B: 330 s, p = 0.016). Notably, the novel approach was linked with significantly larger IJV diameter measured during the procedure (Group A: 18.2 mm, Group B: 12.1 mm, p < 0.001).ConclusionThe novel lateral in-plane short-axis approach for IJV cannulation is a non-inferior alternative with a lower incidence of posterior vessel wall puncture compared to the conventional approach.

Piano sight-reading teaching and music education: A systematic literature review

Piano sight-reading competency, which is highly important for an aspiring musician who needs to face diverse musical problems, is an integral part of becoming a smooth performer. The aims of this systematic literature review concerning piano sight-reading pedagogy approaches between 2019 and 2024 are to determine the strengths and weaknesses of the peer-reviewed literature. The article examines cognitive, behavioral, and technological methods and tools of enhancing learning outcomes, based on the concept of cognitive load, constructivism, and behaviorist perspective. The cognitive strategies highlight the role of hand-eye coordination, short-term memory, and visual process; while the behavioral ones emphasize the importance of daily practice and feedback from the teacher. Emerging technologies, like VR and AI-driven platforms, are redefining education and offering unique ways of learning and forgetting. While achievements of the past are notable, challenges such as access and efficacious long-term approaches remain. The next step of research should be to focus on sustainable teaching methods and international perspectives to achieve homogeneous and effective sight-reading teaching worldwide. This essay provides an overview of integrated and adaptable teaching strategies that combine both traditional and modern tools for the development of versatile and confident musicians’ skills.

Percutaneous VT Ablation via RA-to-LV Access in Patients With Double Mechanical Valves: A Multicenter Registry.

In patients with mechanical aortic and mitral valves requiring catheter ablation of ventricular tachycardia (VT), a technique for access from the right atrium (RA) to the left ventricle (LV) via puncture of the inferoseptal process of the LV was previously described in a single-center series. This study sought to report the multicenter experience of VT ablation using this novel LV access approach. We assembled a multicenter registry of patients with double mechanical valves who underwent VT ablation with RA-to-LV access. Eighteen patients from 10 VT ablation centers were included (15 men; age: 63.9 ± 10 years, LV ejection fraction: 32% ± 10%). In 14 patients, the procedure was performed on uninterrupted anticoagulation, and 4 patients underwent bridging with heparin. A mean of 2.5 VTs were inducible at procedure onset. LV access was successful in all cases with intracardiac echocardiography-guided puncture with a radiofrequency wire (n=16) or standard transseptal needle (n=2), followed by balloon dilation. Postablation, complete noninducibility of VT was achieved in 17 (94%) patients. One intramural perimitral annular hematoma was noted after LV access that was managed conservatively without sequelae. No other procedure-related complications were noted, such as new AV block. LV-RA shunt was present by echocardiogram within 24 to 72 hours in 10 (56%) patients. A small residual shunt was noted in 1 of them more than 3months postablation. During the median follow-up of 10.4months, 3 (17%) patients experienced VT recurrence. In this multicenter registry of patients with double mechanical valves, VT ablation with RA-to-LV access was feasible, safe, and effective.

Bandit-Based Multiple Access Approach for Multi-link Operation in Heterogeneous Dynamic Networks

Bandit-Based Multiple Access Approach for Multi-link Operation in Heterogeneous Dynamic Networks

Positive dementia caregiving in 30 days (PDC30): Study protocol of a randomized controlled trial of a self-guided automated online training program.

The Benefit-Finding Intervention, a face-to-face psychoeducation program with a focus on the positive meanings of caregiving, has been found to reduce depressive symptoms and burden in dementia caregivers. The program was revamped into a computer-delivered web-based program to enable 24/7 access without location restriction. This study evaluates the efficacy of this new online program called Positive Dementia Caregiving in 30 Days (PDC30). A 2-arm (PDC30 vs. waitlist control) parallel-group randomized controlled trial will be conducted. Target sample is 200 mildly depressed dementia family caregivers with internet access and fluency in English, who will be recruited globally through a YouTube video promoted on social media and through service agencies. The primary outcome is depressive symptoms whereas secondary outcomes are anxiety symptoms, burden, and positive gains, all collected at baseline and 1, 2, and 3months. The treatment x time (both linear and quadratic) interaction effects will be examined using mixed-effect regression. Additionally, possible therapeutic mechanisms via strengthened self-efficacy in controlling upsetting thoughts and positive reappraisal coping will be examined in a mediation path model. If positive treatment effects are found, the potential public health benefits, given the ease of access, universal availability, and flexible approach, of this online intervention are considerable.

Development of an ultrasound-guided proximo-medial approach for injection of the carpal flexor tendon sheath in horses and comparison with the conventional proximo-lateral ´blind` technique.

The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established. Subsequently, the technique was validated in ten horses, and its efficacy was compared with the proximo-lateral ´blind` technique. For each injection, the following was recorded: successful injection (contrast within the carpal canal), number of attempts, and whether a structure other than the carpal sheath was penetrated. The ´blind` technique had a total accuracy of 70% (7/10; 95% confidence interval [CI]: CI 35%-93%), with inadvertent injection into the dorso-palmar pouch of the radiocarpal joint, carpal canal surrounding soft tissue, and intravenous injection being the most common issues associated with this approach. In contrast, the ultrasound-guided approach achieved an accuracy of 100% (10/10; 95% confidence interval [CI]: 69%-100%) for intrasynovial administration of the contrast medium. The ultrasound-guided proximo-medial approach for injecting the carpal sheath is an accurate and technically straightforward technique. This approach should be considered for synoviocentesis of the carpal sheath, particularly in horses with no evident effusion.

Radial Access Approach to Peripheral Vascular Interventions: A Scientific Statement From the American Heart Association.

Transradial arterial access has transformed the field of coronary interventions, where it has several advantages over femoral access, such as reduced bleeding and access site complications, improved patient comfort, shorter time to ambulation after the procedure, reduced length of hospital stay, and potentially reduced mortality rates. Because of these benefits, as well as the concurrent expanding indications for various endovascular therapies, there is growing interest in adopting radial access for peripheral vascular interventions. However, radial access can present challenges, and specialized equipment for peripheral interventions through this route are under development. Nevertheless, a growing number of studies, largely comprising single-center and registry data, have broadly suggested that transradial arterial access is likely to be safe and associated with reduced bleeding and local access site complications for most peripheral interventions compared with transfemoral access. Large, prospective randomized trials are lacking, and the question of any effect on mortality rates has not been addressed. Whereas the field of transradial arterial access for peripheral vascular interventions is in development, it is clear that this approach, at least with available equipment, will not be suitable for all patients, and careful case selection is paramount. Furthermore, the remaining knowledge gaps must be addressed, and robust outcome data obtained, to allow full understanding of the factors that determine optimal patient, lesion, and equipment selection. Nevertheless, the use of transradial arterial access for peripheral vascular interventions holds great promise, particularly if the necessary technologic advances are rapid and favorable clinical trial data continue to emerge.

Transperitoneal versus low anterior access single-port pyeloplasty: surgical and functional outcomes from a tertiary referral center.

Transperitoneal approach to robot-assisted pyeloplasty (RAP) have been preferred in the last decades because of the use of multi-port robotic platforms. However, this approach is linked to notable issues, such as pneumoperitoneum and lateral decubitus position, which is associated with potential soft tissues injuries, and it is a time-consuming procedure. Single-port (SP) platform was introduced to potentially address these issues. Our aim was to describe perioperative surgical and functional outcomes of SP-RAP, including our preliminary results comparing the transperitoneal and LAA approaches. Data from a prospectively maintained dataset of all consecutive patients undergoing SP-RAP between 2019 and 2024 were retrospectively reviewed. Early procedures were performed using transperitoneal midline access, while later procedures utilized the low anterior access (LAA) approach. Patients' demographics, perioperative data, and surgical and functional outcomes were collected. Overall, 34 patients underwent the procedure without intraoperative complications or conversion to an alternative approach. The median age was 46.5 (range: 35-56) years. The transperitoneal approach was used for the first 17 (50%) procedures, while the remaining 17 (50%) underwent LAA SP-RAP. Nonoperative room time, postoperative opioid dose, and length of hospital stay were significantly lower in the LAA group (P<0.001 in all cases), with all patients in the LAA group being discharged on the same day. No differences were observed in operative time or postoperative renal function. Outcomes for SP pyeloplasties appear promising, and the LAA approach may help optimize operating room time, promote faster patient recovery, and reduce postoperative opioid use.

Research infrastructure open access approach – Implementation challenges and solutions for accredited calibration laboratories

Research infrastructure open access approach – Implementation challenges and solutions for accredited calibration laboratories

Abstract 4134878: Single Perclose Plus Angioseal Versus Double Perclose for Percutaneous Femoral Access: A Systematic Review and Meta-Analysis

Background: Vascular Closure utilizing Suture Based Devices (SBD) is an established approach for large-bore arterial access in percutaneous procedure patients. Standard of care uses two devices when accessing the artery with 8 Fr sheaths and above. The bailout use of Plug-based devices (PBD) is well established, but little is known about the intentional combination of SBD with PBD and how this technique compares to the standard approach. We aimed to compare these different approaches in this meta-analysis. Methods: PubMed, Scopus, and Cochrane databases were searched for observational studies comparing the hybrid approach to the standard one utilizing exclusively SBDs for arterial closure in large bore vascular access and reported the outcomes of (1) Access-related complications (ARC); (2) Major bleeding; (3) All bleeding events; (4) Need for surgical intervention; (5) Need for endovascular intervention ; (6) Device failure; (7) Pseudoaneurysm. Heterogeneity was examined with I2 statistics. A random-effects model was used for all outcomes. Results: We included five observational studies with 1,586 patients, of whom 1,489 (93.8%) underwent TAVI and 97 (6.1%) EVAR. Sheath size had an average of 20.56 Fr in the EVAR patients. ARC (RR 0.48; 95% CI 0.28-0.81; p&lt;0.01), major bleeding (RR 0.29; 95% CI 0.19-0.44; p&lt;0.01), all bleeding events (RR 0.36; 95% CI 0.23-0.56; p&lt;0.01), surgical intervention (RR 0.28; 95% CI 0.10-0.78; p=0.01), or endovascular intervention (RR 0.53; 95 % CI 0.28-0.98; p=0.04), and device failure (RR 0.28; 95% CI 0.11-0.72; p&lt;0.01) were significantly less common in patients treated with the hybrid technique compared to standard care. Pseudoaneurysm (RR 1.13; 95% CI 0.57-2.25; p=0.71) was not significantly different between groups. Conclusion: These findings suggest the hybrid technique, was associated with fewer access complications compared to the standard double SBD as a closure strategy in patients with large bore arterial access.

Healthcare professionals’ cross-organizational access to electronic health records: A scoping review

BackgroundCross-organizational access to shared electronic health records can enhance integrated, people-centered health services. However, a gap remains between these potential benefits and the limited support currently offered by electronic health records. The Valkyrie research project aims to bridge this gap by developing a technical prototype of an architecture to promote healthcare service coordination. ObjectiveTo inform the Valkyrie project, we aimed to evaluate approaches for healthcare professionals’ access to electronic health records across healthcare providers and identify factors influencing the success and failure of these approaches. Materials and methodsUsing the Joanna Briggs Institute guidance for scoping reviews, searches were conducted in six research databases and grey literature, without limitations on year or language. Papers selected for full-text review were analyzed, and data was extracted using standardized forms that reflected the population, concept, and context framework and the categorization model used in the qualitative analysis of the barriers and facilitators reported in the included papers. ResultsAmong the 290 identified papers, five were deemed eligible for full-text review. The included papers were heterogeneous in country, year of publication, study setting, implementation level, and access approaches to electronic health records, highlighting various techniques, from federated to centralized, for accessing shared electronic health records. Discussion and conclusionThe review did not identify one single superior access approach. However, a hybrid approach incorporating components from the different approaches combined with emerging technologies may benefit the Valkyrie project. The key facilitators were identified as improved information quality and flexible and easy access. In contrast, lack of trust and poor information quality were significant barriers to successful cross-organizational access to electronic health records. Future research should explore alternative access approaches, considering information quality, user training, and collegial trust across healthcare providers.

Novel technique of laparoscopic mid-urethral autologous rectus fascial sling for stress urinary incontinence.

Serious concerns have been raised over the safety of vaginal mesh tapes for stress urinary incontinence (SUI). Autologous rectus fascial sling and the more recent 'sling on a string' through a laparotomy are gaining popularity as native tissue options for SUI. We describe a novel technique of laparoscopic mid-urethral autologous rectus fascial sling for SUI. Ten patients underwent this new technique safely. At 12 months, all patients reported cure of SUI with normal voiding. The advantages of this technique include the minimal access approach, introduction of the sutures under laparoscopic guidance, and avoidance of over-tightening of the sling.

Diastereoselective Construction of Spirocyclic Isobenzofurans via a Tandem Michael Addition/5-Exo-dig Cyclization Reaction.

A practical approach for rapid and efficient access to spirocyclic isobenzofurans is described. The reaction proceeds through the cycloaddition of 1,6-ynenone derivatives and 4-nitro-1,3-diarylbutan-1-ones, promoted by Cs2CO3 in the presence of l-proline as a catalyst. The advantages of this reaction include the formation of two C-C bonds and one C-O bond as well as mild reaction conditions. Extended spirocyclic isobenzofurans are obtained with good efficiency and diastereoselectivity under these mild conditions, and this new protocol avoids the use of any transition-metal reagents.

Improved migration algorithms for uplink transmission secrecy sum rate maximization in MIMO-NOMA

The most significant technology that could assist future high-speed wireless systems in meeting their growing capacity demands is Non-Orthogonal Multiple Access (NOMA). Nevertheless, NOMA should strive to achieve a harmonious equilibrium between equitable distribution among users and optimal network performance. A wireless communication network is a system that enables connections with limited power resources, such as Internet of Things (IoT) devices. Horizontal multiplexing is a feature of MIMO networks that allows for the concurrent transmission of multiple data streams. Nevertheless, there is a correlation between space multiplexing and the advantages of diversity. The issue of Secrecy Sum Rate (SSR) is complex and challenging. To address this, a first-order Taylor estimate is employed to transform the initial problem into a more manageable convex problem. Striking the right balance to optimize network performance and maximize overall rate can be quite challenging, particularly in time-sensitive scenarios. The total rate that can be achieved is reduced due to interference from different users and the use of multiple transmitting antennas. To optimize performance and achieve the highest possible data transmission rate, it is crucial to employ efficient techniques for managing interference. These may include coding methods, adjustments to positioning, or coordinating multiple users. Thus, this work proposes the utilization of optimization to enhance SSR in the MIMONOMA uplink transmission framework. The Singular Value Decomposition (SVD) method is commonly used for the decomposition of channels in the MIMONOMA system. The primary goal of the developed MIMONOMA uplink transmission framework is to enhance the capacity of the Base Station (BS) by optimizing the power allocation measures of the near user and far user using an Improved Migration Algorithm (IMA). In addition, the SSR is optimized and multiple experimental validations are generated to appraise the suggested model. Ultimately, the suggested outcomes are contracted with conventional Orthogonal Multiple Access (OMA) and other traditional approaches to assess the efficacy of the designed model, and developed model given the SSR to be 30bit/s/Hz.

Single arterial access versus standard access in TAVI: results from a large multicenter registry

Abstract Background The transfemoral approach has become the gold standard primary access for transcatheter aortic valve implantation (TAVI) due to low complication rates. An additional secondary access (ScA) is used for angiographic guidance of the procedure. Recently, small, single-center studies demonstrated feasibility of single-access for transfemoral TAVI without a secondary access. However, comparative and large-scale data are missing. Purpose We assessed vascular and bleeding complications of ScA and Single access (SA) approaches in a large multicenter registry to evaluate both strategies. Methods The PULSE registry (Plug or sUture based vascuLar cloSurE after TAVI) retrospectively evaluated data of 10,120 patients who underwent transfemoral TAVI at 10 high-volume German heart centers from 2016 to 2021. In 9,457 patients who qualified for analysis ScA (80.7% femoral, 19.3% radial) were performed in 8709 (92%) and SA in 748 (8%). Outcomes were evaluated in accordance with the Valve Academic Research Consortium (VARC-3) definitions. Results Median age was 81.9[IQR 78.2, 85.1] years and 48.9% of patients were female (median logistic EuroSCORE II: 3.3% [IQR 2.1, 5.6]). Peripheral artery disease was comparable between groups (13.5 vs. 14.0%, p=0.73). While overall major access-related vascular complications did not differ significantly (6.1% vs. 4.8%, p=0.20), there was a higher incidence of minor complications for ScA compared to SA (9.0% vs. 2.8%, p&amp;lt;0.001). Secondary access complications amounted to 2.7% in the ScA group and were mainly characterized as bleeding (1.2%) and pseudoaneurysms (1.2%) mostly treated conservatively (1.2%), yet in some cases surgical repair was needed (0.8%). No significant difference was observed regarding type III/IV bleeding (4.1% vs. 4.3%, p=0.91), stroke rate (2.4% vs. 3.6%, p=0.05), stage III/IV acute kidney injury (2.4% vs. 2.4%, p=1.00) or all-cause 30-day mortality (5.8% and 5.7%, p=0.99) for ScA compared to SA groups. Conclusion In patients treated with transfemoral TAVI, a single access approach was associated with lower rates of minor access-related vascular complications without compromising overall outcomes, suggesting potential benefits of a minimally-invasive TAVI approach with the omission of additional vascular access.

TAVI-related vascular access complications: are Viabahn stents a good option?

Abstract Background Vascular access complications (VACs) remain one of the biggest challenges when performing transcatheter aortic valve implantation (TAVI). Historically, concerns regarding stent placement in flexing points have been a deterrent to the percutaneous treatment of VACs, due to the potential development of claudication over time. The Viabahn stent, being a covered stent that offers flexibility and conformability, may be well-suited for deployment in these anatomies. Purpose This study aimed to evaluate the safety and efficacy of the iliofemoral Viabahn stenting for treating TAVI-related VACs. Methods Retrospective analysis of patients submitted to Viabahn stenting in the iliofemoral sector for TAVI-related VACs in a single tertiary centre between January 2017 and October 2023. Baseline characteristics, procedure data and complications were noted according to the Valve Academic Research Consortium-2. Results A total of 722 patients were submitted to transfemoral TAVI during the study period. Of these, 25 (3.6%) underwent Viabahn stenting to treat TAVI-related VACs and were included in this study. Patient mean age was 82.1±6.13 years, 61.2% were male. At the baseline, patients had a mean Euroscore II of 2.73±1.91. A unilateral access approach was used in 40% of cases. The median size of the main access sheath was 14 Fr [IQ 14-16], and the closure devices deployed were Manta® in 72%, and Perclose® in 28%. The Viabahn stent treated different types of VACS, including vessel rupture in 56%, acute dissection in 28% (12% with no antegrade flow), and failed sealing in 16%. The complicated artery was the common femoral in 82%, and the external iliac in 18%. Percutaneous treatment with Viabahn stenting was successful in 92% of cases. In two cases (8%), one of acute occlusion and one of vessel rupture, vascular surgery was required. During the hospital stay, there were no further vascular or hemorrhagic complications. After a mean follow-up of 15 months, 20% of patients were evaluated by Doppler which showed no signs of restenosis or stent complications. Only one patient experienced lower limb claudication at 1 year due to stent restenosis detected in the CT scan, which was managed with medical therapy. There were no other adverse vascular events during follow-up. Conclusion Our study suggests that Viabahn stenting emerges as a valuable therapeutic option, ensuring long-term safety and efficacy, in the complex realm of TAVI-related vascular complications.