Percutaneous transcatheter aortic valve replacement induces femoral artery shrinkage: angiographic evidence and predictors for a new side effect

Abstract

Percutaneous TAVR induces an angiographically detectable CFA lumen reduction. Such findings call for further studies assessing clinical impact of this phenomenon and open the door for further refinements of the TAVR access management aimed at preserving vessel integrity.

Impact of percutaneous femoral arteriotomy closure using the MANTATM device on vascular and bleeding complications after transcatheter aortic valve replacement

“…Compared to percutaneous suture‐based devices this novel VCD has a shorter learning curve with no risk of postdeployment stenosis which is seen with suture‐based devices and is a potential concern as the scope of TAVR extends to younger, lower risk and more active patients . Furthermore, in the series reported here the operators were experienced with Prostar‐XL and relatively inexperienced with MANTA TM and yet obtained overall comparable access‐related efficacy and in particular fewer major bleeding complications.…”

“…Compared to percutaneous suture-based devices this novel VCD has a shorter learning curve [15] with no risk of postdeployment stenosis which is seen with suture-based devices and is a potential concern as the scope of TAVR extends to younger, lower risk and more active patients [16,17]. Furthermore, in the series reported here the operators percutaneous suture-based VCD with AngioSeal® in the context of balloon aortic valvuloplasty (typically using 9Fr access) reported more frequent minor vascular (3.5% vs 6.9%, P 5 .042) and less frequent requirement for blood transfusion (6.65 vs 3.5%, P 5 .034) respectively for the collagen VCD and similar major vascular complications overall [18].…”

Acute Femoral Occlusion After Adjunctive Angio-Seal Usage in Vascular Closure Following Transcatheter Aortic Valve Replacement

“…Shoeib et al. ( 5 ) have reported the comparison between pre-procedural and post-procedural femoral angiography obtained during TF-TAVR in which a Prostar XL or dual PP were used as closure devices. They found significant shrinkage of the common femoral artery dimensions, with a significant reduction in minimal lumen diameter (5.6 mm after TAVR vs. 6.8 mm before TAVR; p < 0.001) and an increase in the percent diameter stenosis (30.3% after TAVR vs. 17.0% before TAVR; p < 0.001).…”

Long-Term Evolution of Percutaneous Groin Access in Endovascular Aneurysm Repair: A Study of the Sequential Suture and Plug Vascular Closure Devices Technique

“…Nevertheless, access-related complications remain a pressing concern, as they are associated with a signi cantly elevated risk of morbidity and mortality [6][7] . The double suture VCDs technique was conventionally employed for access closure, with reported complication rates ranging from 0-11.4% [5,[9][10][11] . More recently, the suture and plug VCDs technique has emerged as an alternative option for access closure in procedures like transcatheter aortic valve implantation (TAVI) and EVAR [12][13] .…”