Prophylactic retrograde distal common femoral access as a bail-out strategy in patients with increased risk for femoral access complication during transfemoral aortic valve replacement.

•Several patients undergoing TAVR have PAD that increases the risk of vascular closure device (VCD) failure.•In many such patients anatomic or clinical condition prohibits use of contralateral femoral access for rescuing the VCD failure.•We discuss a novel bailout technique for such patients.•The technique involves obtaining a prophylactic additional access in ipsilateral femoral artery distal to the TAVR access.•This technique provides an alternative endovascular bailout strategy for such patients.