Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study

Nardi, Giulia; Saia, Francesco; Søndergaard, Lars; Ristalli, Francesca; Meucci, Francesco; Stolcova, Miroslava; Mattesini, Alessio; Demola, Pierluigi; Wang, Xi; Jabri, Anees Al; Palmerini, Tullio; Bruno, Antonio Giulio; Ielasi, Alfonso; Belle, Éric Van; Berti, Sérgio; Mario, Carlo Di

doi:10.4244/eij-d-21-00581

Cited by 35 publications

(18 citation statements)

References 29 publications

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“…Following a recently reported prospective registry evaluating the use of peripheral IVL to facilitate Tf‐TAVI, 19 the present report represents the second largest data set investigating the feasibility and safety of iliofemoral artery pre‐dilation to allow Tf‐TAVI in patients with advanced PAD. Due to the retrospective, all‐comers nature of the present registry, the vast majority of iliofemoral vessel dilatation was performed by means of noncompliant high‐pressure balloons, with IVL being used in 10.2% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Only recently, initial experience with intravascular lithotripsy (IVL) of the iliofemoral axes to facilitate TAVI was reported with promising results. 19 Against this background, we aimed to investigate the safety and efficacy of percutaneous transluminal angioplasty (PTA)-facilitated Tf-TAVI in a retrospective, all-comers, single-center cohort.…”

Section: Introductionmentioning

confidence: 99%

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Iliofemoral artery predilation prior to transfemoral transcatheter aortic valve implantation in patients with aortic valve stenosis and advanced peripheral artery disease

Alvarez-Covarrubias

Cassese

Warmbrunn

et al. 2023

Cathet Cardio Intervent

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Objectives: To investigate the feasibility and safety of percutaneous transluminal angioplasty (PTA) of the iliofemoral arteries (IFA) before transfemoral transcatheter aortic valve implantation (Tf-TAVI) in patients with advanced peripheral artery disease (PAD). Background: Although Tf-TAVI represents the access of choice, alternative vascular access routes are preferred for patients displaying advanced PAD. PTA of the IFA represents a less invasive option, broadening the spectrum of patients eligible for Tf-TAVI. Methods: All patients requiring PTA of the IFA before Tf-TAVI, between 2012 and 2021, were included. Primary efficacy endpoint was the rate of successful transcatheter heart valve (THV) delivery and implantation. Primary safety endpoint was the rate of PTA and access-site-related vascular complications, procedural-and in-hospital complications.Results: Among 2726 Tf-TAVI procedures, 59 patients required IFA predilation.Successful THV delivery and implantation was achieved in 57 (96.6%) patients, respectively. Sheath placement was achieved in 59 (100%) patients with only one minor dissection and no major vascular complications following iliofemoral PTA.Regarding access site complications, two (3.4%) vessel perforations and one (1.7%) vessel rupture were observed, with eight (13.5%) patients requiring unplanned

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Iliofemoral artery predilation prior to transfemoral transcatheter aortic valve implantation in patients with aortic valve stenosis and advanced peripheral artery disease

Alvarez-Covarrubias

Cassese

Warmbrunn

et al. 2023

Cathet Cardio Intervent

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“…Due to its potential to treat calcified stenotic iliofemoral arteries, IVL can be used to allow transfemoral access in patients who otherwise would need and alternative access [ 21 ]. A European observational multicenter registry reported that IVL was associated with a high procedural success rate (98.2%) and a low rate of complications (1 perforation and 3 major dissections requiring stent implantation) [ 22 ].…”

Section: The Minimalist Tavi Approachmentioning

confidence: 99%

New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023

Tagliari

Taramasso

2023

JCM

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Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious sedation, and the avoidance of invasive lines becoming the new standards. Here, we discuss the minimalist TAVI approach and how we incorporate it into our current clinical practice.

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“…When the intravascular lithotripsy system is activated, electrical discharge vaporizes fluid within the balloon catheter to create rapidly expanding and collapsing bubbles, which in turn generate sonic waves that crack intimal and medial calcium in the PAD vessel walls ( 30 ). Intravascular lithotripsy is more commonly delivered to common and external iliac arteries using a catheter with a 6.0–7.0 mm diameter ( 30 , 31 ). Patients with focal calcific stenosis <20 mm in length requires a minimal luminal diameter of ≥4.0 and ≥3.0 mm for calcified lesions with a circumference of 360° and 270%, respectively.…”

Section: Angioplasty and Intravascular Lithotripsy-assisted Transfemo...mentioning

confidence: 99%

“…In a European TAVR registry, intravascular lithotripsy utility increased from 2.4% in 2018 to 6.5% in 2020. Among the 108 patients treated with intravascular lithotripsy, the success rate of transfemoral delivery of the TAVR system was 100%, and the rate of vascular complication was low with 0.93% and 2.78% in patients having vascular perforation and dissection, respectively ( 31 ).…”

Section: Angioplasty and Intravascular Lithotripsy-assisted Transfemo...mentioning

confidence: 99%

Advances in technology and techniques for transcatheter aortic valve replacement with concomitant peripheral arterial disease

Wong

Chiu²,

Chan³

et al. 2022

Front. Med. Technol.

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Aortic stenosis (AS) is a prevalent disease affecting 3.7% of the adult population aged 65 or above. In the past, surgical aortic valve replacement (SAVR) was the only definitive therapy available for the treatment of severe AS. Owing to the invasive nature of open-heart surgery, patients with advanced age and frailty could not benefit from SAVR. The advent of transcatheter aortic valve replacement (TAVR) in the past decade has offered an alternative treatment option for patients with severe AS, particularly those who are deemed to have high surgical risks. Nevertheless, a large proportion of patients also have concomitant peripheral arterial disease (PAD), which increases the risk of peri-procedural vascular complication, and precludes the possibility of transfemoral TAVR owing to inadequate luminal size for delivery system deployment. In this review, the prevalence and outcome of TAVR patients with PAD will be discussed. Furthermore, novel technologies and techniques that enable TAVR to be safely performed using transfemoral or alternative access in patients with severe PAD will be reviewed.

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Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study

Cited by 35 publications

References 29 publications

Iliofemoral artery predilation prior to transfemoral transcatheter aortic valve implantation in patients with aortic valve stenosis and advanced peripheral artery disease

Iliofemoral artery predilation prior to transfemoral transcatheter aortic valve implantation in patients with aortic valve stenosis and advanced peripheral artery disease

New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023

Advances in technology and techniques for transcatheter aortic valve replacement with concomitant peripheral arterial disease

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