TY - JOUR
T1 - A comparison of the femoral and radial crossover techniques for vascular access management in transcatheter aortic valve implantation
T2 - The milan experience
AU - Curran, Helen
AU - Chieffo, Alaide
AU - Buchanan, Gill Louise
AU - Bernelli, Chiara
AU - Montorfano, Matteo
AU - Maisano, Francesco
AU - Latib, Azeem
AU - Maccagni, Davide
AU - Carlino, Mauro
AU - Figini, Filippo
AU - Cioni, Micaela
AU - Canna, Giovanni La
AU - Covello, Remo Daniel
AU - Franco, Annalisa
AU - Gerli, Chiara
AU - Alfieri, Ottavio
AU - Colombo, Antonio
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Objective To compare radial and femoral crossover techniques (CT) for vascular access management in transcatheter aortic valve implantation (TAVI). Background Femoral crossover for controlled angiography and balloon inflation of the therapeutic access site to facilitate safe vascular closure is beneficial but technically challenging in patients with complex femoral anatomy. An alternative approach should be available. Methods Between June 2011 and March 2012, 41 transfemoral TAVI patients receiving the femoral CT were compared to 46 transfemoral TAVI patients receiving the radial CT. Outcomes were 30-day valve academic research consortium (VARC) endpoints. Results Patients undergoing the radial CT received higher median contrast volumes (150 interquartile range [IQR]: 105-180 vs. 111 IQR: 90-139 ml; P = 0.025) but procedural radiation dose and fluoroscopy times were comparable. Thirty day all cause and cardiovascular death were similar between radial and femoral CT groups (respectively 2.4% vs. 7.9%, P = 0.258 and 0% vs. 7.9%, P = 0.063). There were no differences in major vascular complications (4.3% vs. 7.3%, P = 0.553), life threatening or major bleeding events (respectively 9.1% vs. 19.5%, P = 0.168 and 13.6% vs. 22%, P = 0.315). Conclusion In TAVI cases with unfavorable contralateral femoral anatomy, radial CT for vascular access management is a reasonable alternative to the femoral CT. © 2013 Wiley Periodicals, Inc.
AB - Objective To compare radial and femoral crossover techniques (CT) for vascular access management in transcatheter aortic valve implantation (TAVI). Background Femoral crossover for controlled angiography and balloon inflation of the therapeutic access site to facilitate safe vascular closure is beneficial but technically challenging in patients with complex femoral anatomy. An alternative approach should be available. Methods Between June 2011 and March 2012, 41 transfemoral TAVI patients receiving the femoral CT were compared to 46 transfemoral TAVI patients receiving the radial CT. Outcomes were 30-day valve academic research consortium (VARC) endpoints. Results Patients undergoing the radial CT received higher median contrast volumes (150 interquartile range [IQR]: 105-180 vs. 111 IQR: 90-139 ml; P = 0.025) but procedural radiation dose and fluoroscopy times were comparable. Thirty day all cause and cardiovascular death were similar between radial and femoral CT groups (respectively 2.4% vs. 7.9%, P = 0.258 and 0% vs. 7.9%, P = 0.063). There were no differences in major vascular complications (4.3% vs. 7.3%, P = 0.553), life threatening or major bleeding events (respectively 9.1% vs. 19.5%, P = 0.168 and 13.6% vs. 22%, P = 0.315). Conclusion In TAVI cases with unfavorable contralateral femoral anatomy, radial CT for vascular access management is a reasonable alternative to the femoral CT. © 2013 Wiley Periodicals, Inc.
KW - TAVI
KW - aortic stenosis
KW - vascular closure device
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U2 - 10.1002/ccd.24913
DO - 10.1002/ccd.24913
M3 - Article
C2 - 23475626
AN - SCOPUS:84890566839
SN - 1522-1946
VL - 83
SP - 156
EP - 161
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -