RT Journal Article
T1 Comparison of Transfemoral Versus Transradial Secondary Access in Transcatheter Aortic Valve Replacement.
A1 Junquera, Lucía
A1 Urena, Marina
A1 Latib, Azeem
A1 Muñoz-Garcia, Antonio
A1 Nombela-Franco, Luis
A1 Faurie, Benjamin
A1 Veiga-Fernandez, Gabriela
A1 Alperi, Alberto
A1 Serra, Vicenç
A1 Regueiro, Ander
A1 Fischer, Quentin
A1 Himbert, Dominique
A1 Mangieri, Antonio
A1 Colombo, Antonio
A1 Muñoz-García, Erika
A1 Vera-Urquiza, Rafael
A1 Jiménez-Quevedo, Pilar
A1 de la Torre, Jose Maria
A1 Pascual, Isaac
A1 Garcia Del Blanco, Bruno
A1 Sabaté, Manel
A1 Mohammadi, Siamak
A1 Freitas-Ferraz, Afonso B
A1 Guimarães, Leonardo
A1 Couture, Thomas
A1 Côté, Melanie
A1 Rodés-Cabau, Josep
K1 acute kidney injury
K1 bleeding
K1 femoral artery
K1 radial artery
K1 stroke
K1 transcatheter aortic valve replacement
K1 vascular complications
AB Transfemoral approach has been commonly used as secondary access in transcatheter aortic valve replacement (TAVR). Scarce data exist on the use and potential clinical benefits of the transradial approach as secondary access during TAVR procedures. The objective of the study is to determine the occurrence of vascular complications (VC) and clinical outcomes according to secondary access (transfemoral versus transradial) in patients undergoing TAVR. This was a multicenter study including 4949 patients who underwent TAVR (mean age, 81±8 years, mean Society of Thoracic Surgeons score, 4.9 [3.3-7.5]). Transfemoral and transradial approaches were used as secondary access in 4016 (81.1%) and 933 (18.9%) patients, respectively. The 30-day clinical events (vascular and bleeding complications, stroke, acute kidney injury, and mortality) were evaluated and defined according to Valve Academic Research Consortium-2 criteria. Clinical outcomes were analyzed according to the secondary access (transfemoral versus transradial) in the overall population and in a propensity score-matched population involving 2978 transfemoral and 928 transradial patients. Related-access VC occurred in 834 (16.9%) patients (major VC, 5.7%) and were related to the secondary access in 172 (3.5%) patients (major VC, 1.3%). The rate of VC related to the secondary access was higher in the transfemoral group (VC, 4.1% versus 0.9%, P The use of transradial approach as secondary access in TAVR procedures was associated with a significant reduction in vascular and bleeding complications and improved 30-day outcomes. Future randomized studies are warranted.
YR 2020
FD 2020-02-24
LK http://hdl.handle.net/10668/15150
UL http://hdl.handle.net/10668/15150
LA en
DS RISalud
RD Apr 17, 2025