Use of Two-Dimensional Ultrasonographically Guided Access to Reduce Access-Related Complications for Transcatheter Aortic Valve Replacement

Elbaz‐Greener, Gabby; Zivkovic, Nevena; Arbel, Yaron; Radhakrishnan, Sam; Fremes, Stephen E.; Wijeysundera, Harindra C.

doi:10.1016/j.cjca.2017.03.025

Cited by 34 publications

(38 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In line with existing TAVR and EVAR literature, 14,15 US-guided femoral puncture significantly reduced access-site complications, driven predominantly by a reduction in minor access site complications. Notably, the observed major and minor access complication rates in our cohort were comparable to published randomized and observational data.…”

Section: Us-guided Femoral Puncturesupporting

confidence: 70%

“…Rapid pacing through the left ventricle guidewire (LV-GW) has been proposed as an alternative to right ventricle temporary wire pacing (RV-TPW), 13 while an US-guided vascular access management strategy may reduce access-related complications. [14][15][16] The aim of the study was to identify clinical and procedural practice predictors of avoidable complications during TAVR.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Kotronias

Scarsini

Maria

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives: To identify clinical and procedural practice predictors of avoidable complications during transcatheter aortic valve replacement (TAVR). Background: TAVR is evolving as a viable strategy for treatment of aortic stenosis (AS). Vascular complications, major bleeding, or pericardial tamponade may be influenced by procedural practice. Methods: The Oxford TAVR (OxTAVI) prospective registry was retrospectively analyzed to identify predictors of avoidable procedural complications in a contemporary cohort of transfemoral TAVR between January 2015 and September 2018. The primary endpoint was defined as a hierarchic composite of in-hospital mortality, pericardial effusion/cardiac tamponade, major bleeding, and vascular access complications. Individual components of the primary endpoint have been analyzed separately. Results: Five-hundred-twenty-nine patients underwent transfemoral TAVR using contemporary techniques during the study period and were enrolled in the OxTAVI registry. Female sex and high frailty were associated with a higher risk of death, major bleeding, vascular complication or pericardial tamponade. The use of ultrasound (US) guidance for vascular access management was independently associated with a reduced composite primary endpoint (OR = 0.35,

show abstract

Section: Us-guided Femoral Puncturesupporting

confidence: 70%

Section: Resultsmentioning

confidence: 99%

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Kotronias

Scarsini

Maria

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Dudeck and colleagues have already reported such benefits in the UGC group versus SA, but only for obese patients or subjects presenting with a weak pulse [17]. Likewise, a single-center retrospective cohort study including 387 patients who underwent trans-femoral TAVR, showed that, compared to a standard access group, UGC-patients were less likely to experience access site complications and major bleeding events [23,24].…”

Section: Discussionmentioning

confidence: 99%

Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials

Sorrentino

Nguyen

Salerno

et al. 2020

JCM

View full text Add to dashboard Cite

Background: It is unclear whether or not ultrasound-guided cannulation (UGC) of the femoral artery is superior to the standard approach (SA) in reducing vascular complications and improving access success. Objective: We sought to compare procedural and clinical outcomes of femoral UGC versus SA in patients undergoing percutaneous cardiovascular intervention (PCvI). Methods: We searched EMBASE, MEDLINE, Scopus and web sources for randomized trials comparing UGC versus SA. We estimated risk ratio (RR) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) for categorical and continuous variables, respectively. Primary efficacy endpoint was the success rate at the first attempt, while secondary efficacy endpoints were access time and number of attempts. Primary safety endpoints were the rates of vascular complications, while secondary endpoints were major bleeding, as well as access site hematoma, venepuncture, pseudoaneurysms and retroperitoneal hematoma. This meta-analysis has been registered on Centre for Open Science (OSF) (osf.io/fy82e). Results: Seven trials were included, randomizing 3180 patients to UGC (n = 1564) or SA (n = 1616). Efficacy between UGC and SA was the main metric assessed in most of the trials, in which one third of the enrolled patients underwent interventional procedures. The success rate of the first attempt was significantly higher with UGC compared to SA, (82.0% vs. 58.7%; RR: 1.36; 95% CI: 1.17 to 1.57; p < 0.0001; I2 = 88%). Time to access and number of attempts were significantly reduced with UGC compared to SA (SMD: −0.19; 95% CI: −0.28 to −0.10; p < 0.0001; I2 = 22%) and (SMD: −0.40; 95% CI: −0.58 to −0.21; p < 0.0001; I2 = 82%), respectively. Compared with SA, use of UGC was associated with a significant reduction in vascular complications (1.3% vs. 3.0%; RR: 0.48; CI 95%: 0.25 to 0.91; p = 0.02; I2 = 0%) and access-site hematoma (1.2% vs. 3.3%; RR: 0.41; CI 95%: 0.20 to 0.83; p = 0.01; I2 = 27%), but there were non-significant differences in major bleeding (0.7% vs. 1.4%; RR: 0.57; CI 95%: 0.24 to 1.32; p = 0.19; I2 = 0%). Rates of venepuncture were lower with UGC (3.6% vs. 12.1%; RR: 0.32; CI 95%: 0.20 to 0.52; p < 0.00001; I2 = 55%). Conclusion: This study, which included all available data to date, demonstrated that, compared to a standard approach, ultrasound-guided cannulation of the femoral artery is associated with lower access-related complications and higher efficacy rates. These results could be of great clinical relevance especially in the femoral cannulation of high risk patients.

show abstract

“…Furthermore, the sheath‐to‐femoral artery ratio (SFAR) in the MANTA TM group was <1.05 indicating a low risk of vascular complications , although the importance of this ratio in predicting access in contemporary practice has been questioned . The ultrasound‐guided method of puncture may also have influenced the outcomes toward lower complications .…”

Section: Discussionmentioning

confidence: 99%

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

Palma

Settergren

Rück

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Use of Two-Dimensional Ultrasonographically Guided Access to Reduce Access-Related Complications for Transcatheter Aortic Valve Replacement

Cited by 34 publications

References 22 publications

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials

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

Contact Info

Product

Resources

About

Use of Two-Dimensional Ultrasonographically Guided Access to Reduce Access-Related Complications for Transcatheter Aortic Valve Replacement

Cited by 34 publications

References 22 publications

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry

Standard Versus Ultrasound-Guided Cannulation of the Femoral Artery in Patients Undergoing Invasive Procedures: A Meta-Analysis of Randomized Controlled Trials

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

Contact Info

Product

Resources

About

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