A comparative study on iliofemoral artery calcification distribution in alternative TAVR approaches.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI:10.1007/s12055-024-01841-3

Yu Hohri, Kan Zen, Hidetake Kawajiri, Masaki Yashige, Tomotaka Fujimoto, Shunsuke Nakamura, Ryotaro Tani, Satoaki Matoba

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引用次数: 0

Abstract

Background: Alternative access approaches are required for transcatheter aortic valve replacement (TAVR) cases wherein the transfemoral approach is restrictive with severe calcification. We aimed to examine the safety of the external iliac artery (EIA) as an alternative access site by evaluating the calcification distributions from the common iliac artery (CIA) to the common femoral arteries (CFA).

Methods: We retrospectively enrolled 402 patients who underwent TAVR. Using computed tomography, calcification was visually assessed based on the maximal circumferential involvement, length, and morphology, and its volumes were quantitatively measured using a minimum threshold of 600 Hounsfield units in 804 arteries.

Results: The calcification volumes were 0.301 (interquartile range, 0.114-0.624) cc in the CIA, 0.0 (0.0-0.041) cc in the EIA, and 0.047 (0.002-0.158) cc in the CFA (p < 0.01). Maximum calcification of >50% of the arterial circumference was observed in only 7.3% of the EIA, compared to 35.2% and 10.8% of the CIA and CFA, respectively. Almost 55% of the EIA had no calcification, compared with only <5% and 22.7% of the CIA and CFA, respectively. In a subgroup analysis of patients on dialysis, the calcification volume was smallest in the EIA at 0.011 (0.0-0.127) cc (p < 0.01). In all, 33.3% of EIAs had no calcification, while 2.0% of CIAs and 19.6% of CFAs were calcification-free.

Conclusions: Calcification rarely presents qualitatively and quantitatively in the EIA, suggesting that it could be an option for TAVR when the transfemoral access is unsuitable.

Graphical abstract: We qualitatively and quantitatively evaluated the distribution of calcification in the iliofemoral arteries of patients who underwent TAVR. The calcification was more rarely present in the EIA than in the CIA or CFA.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01841-3.

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.