A Novel Risk Score Facilitates Femoral Artery Access in Transcatheter Aortic Valve Implantation: Passage-Puncture Score

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Mi Chen MD, PhD , Jonathan Michel MD , Barbara E. Stähli MD, MPH, MBA, Christian Templin MD, PhD, Philipp Jakob MD, Thomas S. Gilhofer MD, Felix C. Tanner MD, Albert Markus Kasel MD
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引用次数: 0

Abstract

Background

Vascular complications remain high in transfemoral transcatheter aortic valve implantation (TAVI). Careful evaluation of the femoral arteries is important to select the optimal access site.

Objectives

This study sought to describe a novel risk score (the passage-puncture score) for transfemoral access using a single suture-based closure system.

Methods

The passage-puncture score consists of the evaluation of 1) passage feasibility of the ilio-femoral arteries (passage score) and 2) puncture site feasibility (puncture score) based on pre-TAVI computed tomography. All patients underwent fluoroscopy-guided arterial puncture and closure with a suture-based closure system. The primary endpoint was the rate of vascular complications in discharge, including minor and major vascular complications according to the definitions of the Third Valve Academic Research Consortium.

Results

From September 2020 to June 2021, transfemoral TAVI was performed in 98 of 99 patients. Passage score (right) was significantly higher in patients treated by left compared to those treated by right femoral access (3 vs. 1; p <0.001). Puncture score was significantly different between patients undergoing mid-femoral as compared to nonmid-femoral puncture (0 vs. 3, p <0.001). Minor vascular complications occurred in six (6%) patients.

Conclusions

The passage-puncture score is effective in defining the optimal access site for transfemoral TAVI. The systematic evaluation has the potential to further reduce access-site complications.

Abstract Image

一种新的风险评分方法有助于经导管主动脉瓣植入术中的股动脉入路:通道穿刺评分
背景经胸主动脉瓣植入术(TAVI)的血管并发症仍然很高。仔细评估股动脉对选择最佳入路部位非常重要。本研究试图描述一种新的风险评分(通过-穿刺评分),用于使用单一缝合闭合系统的经股动脉入路。方法通过-穿刺评分包括根据 TAVI 术前计算机断层扫描评估 1)髂股动脉通过可行性(通过评分)和 2)穿刺部位可行性(穿刺评分)。所有患者都在透视引导下进行了动脉穿刺,并使用缝合闭合系统进行了闭合。主要终点是出院时的血管并发症发生率,包括根据第三瓣膜学术研究联盟定义的轻微和主要血管并发症。结果2020年9月至2021年6月,99例患者中有98例进行了经股动脉TAVI。与右股动脉入路相比,左股动脉入路患者的通过评分(右)明显更高(3 vs. 1; p <0.001)。接受股中穿刺的患者与接受非股中穿刺的患者相比,穿刺评分有明显差异(0 对 3,p <0.001)。结论穿刺评分能有效确定经股动脉 TAVI 的最佳入路部位。结论穿刺评分能有效确定经股动脉 TAVI 的最佳入路部位,系统性评估有可能进一步减少入路部位并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Structural Heart
Structural Heart Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.60
自引率
0.00%
发文量
81
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