Abstract
Though transcatheter aortic valve implantation (TAVI) has given ample proof of being a safe procedure, it is not devoid of complications. Peripheral vascular complications and bleeding at the access site are still among the problems most frequently associated with transfemoral TAVI. The transfemoral route is the access of first choice, and the improvement of TAVI devices has made it possible to reduce the size of introducers and delivery systems from the initial 22–24 Fr of the early devices to 18 Fr, first, and now to the 14–16 Fr of many new-generation devices. This has made it possible to broaden the range of indications treated with the transfemoral approach to serve a larger number of patients.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Owen AR, Roditi GH. Peripheral arterial disease: the evolving role of non-invasive imaging. Postgrad Med J. 2011;87:189–98.
Zemedkun M, LaBounty TM, Bergman G, Wong SC, Lin FY, Reynolds D, Gomez M, Dunning AM, Leipsic J, Min JK. Effectiveness of a low contrast load CT angiography protocol in octogenarians and nonagenarians being evaluated for transcatheter aortic valve replacement. Clin Imaging. 2015;39(5):815–9.
Toggweiler S, Gurvitch R, Leipsic J, Wood DA, Willson AB, Binder RK, Cheung A, Ye J, Webb JG. Percutaneous aortic valve replacement: vascular outcomes with a fully percutaneous procedure. J Am Coll Cardiol. 2012;59:113.
Arthurs ZM, Bishop PD, Feiten LE, Eagleton MJ, Clair DG, Kashyap VS. Evaluation of peripheral atherosclerosis: a comparative analysis of angiography and intravascular ultrasound imaging. J Vasc Surg. 2010;51:933–8.
Collins R, Burch J, Cranny G, Aguiar-Ibáñez R, Craig D, Wright K, Berry E, Gough M, Kleijnen J, Westwood M. Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review. BMJ. 2007;334:1257.
Webb JG, Altwegg L, Boone RH, Cheung A, Ye J, Lichtenstein S, Lee M, Masson JB, Thompson C, Moss R, Carere R, Munt B, Nietlispach F, Humphries K. Transcatheter aortic valve implantation: impact on clinical and valve-related outcomes. Circulation. 2009;119:3009–16.
Toggweiler S, Webb J. Challenges in transcatheter aortic valve implantation. Swiss Med Wkly. 2012;142:w13735.
Barbash IM, Barbanti M, Webb J, Molina-Martin De Nicolas J, Abramowitz Y, Latib A, Nguyen C, Deuschl F, Segev A, Sideris K, Buccheri S, Simonato M, Rosa FD, Tamburino C, Jilaihawi H, Miyazaki T, Himbert D, Schofer N, Guetta V, Bleiziffer S, Tchetche D, Immè S, Makkar RR, Vahanian A, Treede H, Lange R, Colombo A, Dvir D. Comparison of vascular closure devices for access site closure after transfemoral aortic valve implantation. Eur Heart J. 2015;36:3370–9.
Barbanti M, Binder RK, Freeman M, Wood DA, Leipsic J, Cheung A, Ye J, Tan J, Toggweiler S, Yang TH, Dvir D, Maryniak K, Lauck S, Webb JG. Impact of low-profile sheaths on vascular complications during transfemoral transcatheter aortic valve replacement. EuroIntervention. 2013;9:929–35.
Grube E, Schuler G, Buellesfeld L, Gerckens U, Linke A, Wenaweser P, Sauren B, Mohr FW, Walther T, Zickmann B, Iversen S, Felderhoff T, Cartier R, Bonan R. Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome. J Am Coll Cardiol. 2007;50:69–76.
Piazza N, Grube E, Gerckens U, den Heijer P, Linke A, Luha O, Ramondo A, Ussia G, Wenaweser P, Windecker S, Laborde JC, de Jaegere P, Serruys PW. Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) CoreValve revalving system: results from the multicentre, expanded evaluation registry 1-year following CE mark approval. EuroIntervention. 2008;4:242–9.
Thomas M, Schymik G, Walther T, Himbert D, Lefevre T, Treede H, Eggebrecht H, Rubino P, Colombo A, Lange R, Schwarz RR, Wendler O. One-year outcomes of cohort 1 in the edwards SAPIEN aortic bioprosthesis European outcome (SOURCE) registry: the European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation. 2011;124:425–33.
Petronio AS, De Carlo M, Bedogni F, Maisano F, Ettori F, Klugmann S, Poli A, Marzocchi A, Santoro G, Napodano M, Ussia GP, Giannini C, Brambilla N, Colombo A. 2-year results of CoreValve implantation through the subclavian access: a propensity-matched comparison with the femoral access. J Am Coll Cardiol. 2012;60:502–7.
Muensterer A, Mazzitelli D, Ruge H, Wagner A, Hettich I, Piazza N, Lange R, Bleiziffer S. Safety and efficacy of the subcla- vian access route for TAVI in cases of missing transfemoral access. Clin Res Cardiol. 2013;102(9):627–36.
Modine T, Sudre A, Collet F, Delhaye C, Lemesles G, Fayad G, Koussa M. Transcutaneous aortic valve implantation using the axillary/subclavian access with patent left internal tho- racic artery to left anterior descending artery: feasibility and early clinical outcomes. J Thorac Cardiovasc Surg. 2012;144:1416–20.
Kliger C, Jelnin V, Sharma S, Panagopoulos G, Einhorn BN, Kumar R, Cuesta F, Maranan L, Kronzon I, Carelsen B, Cohen H, Perk G, Van Den Boomen R, Sahyoun C, Ruiz CE. CT angiography-fluoroscopy fusion imaging for percutaneous transapical access. JACC Cardiovasc Imaging. 2014;7:169–77.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Barbanti, M., Pilato, G., Sgroi, C. (2018). Vascular Access Management in Transcatheter Aortic Valve Implantation. In: Tamburino, C., Barbanti, M., Capodanno, D. (eds) Percutaneous Treatment of Left Side Cardiac Valves. Springer, Cham. https://doi.org/10.1007/978-3-319-59620-4_18
Download citation
DOI: https://doi.org/10.1007/978-3-319-59620-4_18
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59619-8
Online ISBN: 978-3-319-59620-4
eBook Packages: MedicineMedicine (R0)