In many of the areas in the west you can get pretty far back in with a good 4x4 pickup. What we do is go in by vehicle as far as we can and set up a main camp that consists of a couple of wall tents, stoves etc... That's the base. Then we go farther back in and set some smaller spike camps and rotate between them. The base camp usually stays up for about 3 weeks unless the weather goes south. One year we had to pull out and the camp stayed until the next summer when we could get back in. This happened when a 40 inch blizzard blew through in early Oct and effectively shut down the high country for the winter.

As to getting it out, I've packed a number of elk out on my back. I bone them where they hit the ground and only bring out edible meat (and antlers if the law requires it) and I leave the guts, bones, skin etc... for the coyotes. An average mature bull elk will weigh about 600 lbs and an average mature cow will go about 400. Only about 42% of that weight is edible meat. So I can get a bull out in 4 trips and a cow in 3. I carry a packframe with me so the first load comes out right after the kill. The farthest I've packed an elk was 6 miles one way. That was a really big 5x5 and it took me 4 trips and 2 full days. Of the 25 elk I've shot I've only been able to drive to 2 of them and the rest came out via packframe and ankle express. It is a lot different than just skidding a 150 whitetail out of a wood lot.