Comparison of Frequency of Vascular Complications With Ultrasound-Guided Versus Fluroscopic Roadmap-Guided Femoral Arterial Access in Patients Who Underwent Transcatheter Aortic Valve Implantation
Section snippets
Methods
A retrospective review of all TF-TAVI procedures performed in a single center between July 2012 and July 2017 was conducted. All patients implanted with both balloon expandable or self-expanding valves were included with sheath size ranging from 14-Fr to 20-Fr. We excluded patients who underwent TF-TAVI with the first generation SAPIEN (Edwards Lifesciences, Irvine, CA) due to the larger sheath size and in order to maintain a patient population most representative of contemporary practice. All
Results
A total of 612 TAVI patients were included in the study; 380 (62.1%) with USG, and 232 (37.9%) with FG. The year 2015 was the inflection point for access guidance (USG access: 52%; FG access 48%) with higher USG use afterward (Figure 3). Patients who underwent USG access were more commonly female, younger, with lower STS score, and higher BMI (Table 1). The prevalence of diabetes, hypertension, and coronary artery disease were similar between the 2 groups. Patients with USG access had a median
Discussion
Our study conducted in a single center, demonstrates that USG access for TAVI is associated with a significant reduction in access-related vascular complications compared with conventional FG access. This association remains significant even after adjusting for various potential confounders including differences in patient co-morbidities, STS score and SFAR. Our study also showed a decrease in VARC-2 vascular complications over time, with a 3.9% rate of vascular complications with the use of
Disclosures
Dr. Srinivasa Potluri is a speaker and on the advisory panel for Boston Scientific, Edwards, Medtrontic, Janssen, and Terumo. The authors declare that they have no known competing financial interests or personal relations that could have appeared to influence the work reported in this study.
Authors’ Contribution
Srinivasa P. Potluri, Mohanad Hamandi, Sukhdeep S. Basra: Writing- Original draft preparation, methodology.
Kathryn V. Shinn, Deborah Tabachnick, Anupama Vasudevan, Giovanni Filardo: Data curation and data analysis
J. Michael DiMaio, William T. Brinkman, Katherine Harrington, John J. Squiers, Molly I. Szerlip, David L. Brown, Elizabeth Holper, Michael J. Mack: Writing - Reviewing and Editing.
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