Vascular Access Site Complications after Percutaneous Transfemoral Aortic Valve Implantation

Kahlert, Philipp; Al–Rashid, Fadi; Weber, Marcel; Wendt, Daniel; Heine, T.; Kottenberg, Eva; Thielmann, Matthias; Kühl, Hilmar; Peters, Jürgen; Jakob, Heinz; Sack, Stefan; Erbel, Raimund; Eggebrecht, Holger

doi:10.1007/s00059-009-3252-3

Cited by 97 publications

(55 citation statements)

References 34 publications

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“…However, despite the less invasive approach, serious adverse events including major vascular complications are still reported with an incidence of 7-15% [5][6][7]. Although vascular complications may affect procedural results, contributing factors have not been well defined [8,9]. Therefore, the purpose of this study was to record the incidence and identify angiographic predictors of vascular complications after TAVI, in patients in whom vascular access-site closure was exclusively performed with the Prostar device.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors of Vascular Complications after Transcatheter Aortic Valve Implantation in Patients Treated with a Default Percutaneous Strategy

Vavuranakis

Kariori

Voudris

et al. 2013

Cardiovascular Therapeutics

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Section: Introductionmentioning

confidence: 99%

Predictive Factors of Vascular Complications after Transcatheter Aortic Valve Implantation in Patients Treated with a Default Percutaneous Strategy

Vavuranakis

Kariori

Voudris

et al. 2013

Cardiovascular Therapeutics

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“…Vascular complications are not rare in TAVI by the transfemoral approach and can significantly affect the overall clinical outcome [8][9][10] . At the end of the TAVI procedure, a control angiography obtained from the contralateral femoral access site allows early identification of vascular access site complications.…”

Section: Resultsmentioning

confidence: 99%

“…A series of vascular complications are commonly reported to be associated with TAVI, including arterial perforation, dissection, pseudoaneurysm, stenosis/occlusion and arterio-venous fistula [7][8][9][10] . The VARC, a collaboration between academic research organizations in the United States and Europe, has elaborated a consensus document on TAVI related endpoint definitions [36] and a more recent updated document [37] , in which a classification of major and minor vascular access complications has been proposed ( Table 1).…”

Section: Vascular Access Site Complications After Tavi and Their Manamentioning

confidence: 99%

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Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation

Dato

Burzotta

Trani

et al. 2014

WJC

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Transcatheter aortic valve implantation (TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths (16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Transfemoral transcatheter aortic valve implantation; Vascular access complication; Percutaneous managementCore tip: Vascular complications are not rare in transcatheter aortic valve implantation (TAVI) by the transfemoral approach and can significantly affect the overall clinical outcome. After diagnosis, the application of simple vascular interventional techniques allows efficient complication management, thus avoiding high risk vascular surgery. We discuss the available percutaneous vascular access preparation by dedicated devices, the principal diagnostic tools for prevention and detection of vascular complications and their percutaneous management in the transfemoral TAVI setting.Dato I, Burzotta F, Trani C, Crea F, Ussia GP. Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation.

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“…These complications most frequently occur in the iliofemoral region. In previous studies, TAVI-induced vascular complication rates were reported to be 1.9%-17.3% (21,22,31) . In our study, however, vascular complication occurred in a total of 18 (16.4%) patients.…”

Section: Percutaneous Closure Device Failurementioning

confidence: 98%

Importance of Femoral Access Method in Predicting the Development of Contrast Induced Nephropathy after Transfemoral Transcatheter Aortic Valve Implantation

Gül¹,

Zungur²,

Taştan³

et al. 2016

Kosuyolu Heart Journal

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Introduction: Transcatheter aortic valve implantation (TAVI) is more reliable than surgical valve replacement for high-risk or inoperable aortic stenosis patients. In this study, we aimed to investigate the effects of different femoral access methods on the development of vascular complications and contrast-induced nephropathy (CIN) after transfemoral (TF)-TAVI. Patients and Methods:In total, 110 patients (aged 78.9 ± 12.2 years; 55 females) who underwent aortic valve replacement by TF-TAVI between June 2013 and April 2015 were included in the study. CIN was defi ned as an absolute increase in serum creatinine level of > 0.5 mg/dL or a relative increase of > 25% within 48-72 h after TF-TAVI. The patients were classifi ed into two groups according to the femoral access methods: surgical cut-down (SCD) and vascular closure device (VCD) groups. Results:The amount of contrast medium (CM; p< 0.001) and the incidence of CIN (p= 0.038) were higher in the VCD group. Baseline glomerular fi ltration rate (GFR), baseline creatinine, Mehran score and CM were determined as the predictive factors of CIN development. Receiver operating characteristic analysis revealed that CM, which may predict the development of CIN, was determined as 178.5 mL, and GFR, which may predict the development of CIN, was determined as 48.9 mL/dk/1.73 m 2 .Conclusion: It may be preferred to perform the femoral arterial procedure using the SCD method instead of VCD in TAVI patients whose GFR is < 48.9; the use of CM may increase due to various reasons.

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Vascular Access Site Complications after Percutaneous Transfemoral Aortic Valve Implantation

Cited by 97 publications

References 34 publications

Predictive Factors of Vascular Complications after Transcatheter Aortic Valve Implantation in Patients Treated with a Default Percutaneous Strategy

Predictive Factors of Vascular Complications after Transcatheter Aortic Valve Implantation in Patients Treated with a Default Percutaneous Strategy

Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation

Importance of Femoral Access Method in Predicting the Development of Contrast Induced Nephropathy after Transfemoral Transcatheter Aortic Valve Implantation

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