Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement. / Dencker, Ditte; Taudorf, Mikkel; Luk, N H Vincent; Nielsen, Michael B; Kofoed, Klaus F; Schroeder, Torben V; Søndergaard, Lars; Lönn, Lars; De Backer, Ole.

In: American Journal of Cardiology, Vol. 118, No. 8, 15.10.2016, p. 1244-1250.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Dencker, D, Taudorf, M, Luk, NHV, Nielsen, MB, Kofoed, KF, Schroeder, TV, Søndergaard, L, Lönn, L & De Backer, O 2016, 'Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement', American Journal of Cardiology, vol. 118, no. 8, pp. 1244-1250. https://doi.org/10.1016/j.amjcard.2016.07.045

APA

Dencker, D., Taudorf, M., Luk, N. H. V., Nielsen, M. B., Kofoed, K. F., Schroeder, T. V., Søndergaard, L., Lönn, L., & De Backer, O. (2016). Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement. American Journal of Cardiology, 118(8), 1244-1250. https://doi.org/10.1016/j.amjcard.2016.07.045

Vancouver

Dencker D, Taudorf M, Luk NHV, Nielsen MB, Kofoed KF, Schroeder TV et al. Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement. American Journal of Cardiology. 2016 Oct 15;118(8):1244-1250. https://doi.org/10.1016/j.amjcard.2016.07.045

Author

Dencker, Ditte ; Taudorf, Mikkel ; Luk, N H Vincent ; Nielsen, Michael B ; Kofoed, Klaus F ; Schroeder, Torben V ; Søndergaard, Lars ; Lönn, Lars ; De Backer, Ole. / Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement. In: American Journal of Cardiology. 2016 ; Vol. 118, No. 8. pp. 1244-1250.

Bibtex

@article{8f50fbe8287b4616aa178368dd41b349,

title = "Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement",

abstract = "Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365 patients underwent TAVR and 333 patients (94%) were treated by true percutaneous transfemoral approach. Of this latter group, 83 patients (25%) had an access-related vascular injury that was managed by the use of a covered self-expanding stent (n = 49), balloon angioplasty (n = 33), or by surgical intervention (n = 1). In 16 patients (5%), the vascular injury was classified as a major vascular complication. Absence of a preprocedural computed tomography angiography (CTA) of the iliofemoral arteries (OR 2.04, p = 0.007) and female gender (OR 2.18, p = 0.004) were independent predictors of the need for access-related vascular intervention. In addition, a high sheath/common femoral artery ratio as measured on preoperative CTA was associated with a higher rate of post-TAVR vascular intervention. The radiation dose, iodine contrast volume, transfusion need, length of hospitalization, and 30-day mortality were not significantly different between patients with versus without access-related vascular intervention. In conclusion, access-related vascular intervention in patients who underwent transfemoral-TAVR is not uncommon. Female gender and a high sheath/common femoral artery ratio are risk factors for access-related vascular injury, whereas preprocedural planning with CTA of the access vessels may reduce the risk of vascular injury. Importantly, most access-related vascular injuries may be treated by percutaneous techniques with similar clinical outcomes to patients without vascular injuries.",

keywords = "Journal Article",

author = "Ditte Dencker and Mikkel Taudorf and Luk, {N H Vincent} and Nielsen, {Michael B} and Kofoed, {Klaus F} and Schroeder, {Torben V} and Lars S{\o}ndergaard and Lars L{\"o}nn and {De Backer}, Ole",

year = "2016",

month = oct,

day = "15",

doi = "10.1016/j.amjcard.2016.07.045",

language = "English",

volume = "118",

pages = "1244--1250",

journal = "Am. J. Cardiol.",

issn = "0002-9149",

publisher = "Elsevier",

number = "8",

}

RIS

TY - JOUR

T1 - Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement

AU - Dencker, Ditte

AU - Taudorf, Mikkel

AU - Luk, N H Vincent

AU - Nielsen, Michael B

AU - Kofoed, Klaus F

AU - Schroeder, Torben V

AU - Søndergaard, Lars

AU - Lönn, Lars

AU - De Backer, Ole

PY - 2016/10/15

Y1 - 2016/10/15

N2 - Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365 patients underwent TAVR and 333 patients (94%) were treated by true percutaneous transfemoral approach. Of this latter group, 83 patients (25%) had an access-related vascular injury that was managed by the use of a covered self-expanding stent (n = 49), balloon angioplasty (n = 33), or by surgical intervention (n = 1). In 16 patients (5%), the vascular injury was classified as a major vascular complication. Absence of a preprocedural computed tomography angiography (CTA) of the iliofemoral arteries (OR 2.04, p = 0.007) and female gender (OR 2.18, p = 0.004) were independent predictors of the need for access-related vascular intervention. In addition, a high sheath/common femoral artery ratio as measured on preoperative CTA was associated with a higher rate of post-TAVR vascular intervention. The radiation dose, iodine contrast volume, transfusion need, length of hospitalization, and 30-day mortality were not significantly different between patients with versus without access-related vascular intervention. In conclusion, access-related vascular intervention in patients who underwent transfemoral-TAVR is not uncommon. Female gender and a high sheath/common femoral artery ratio are risk factors for access-related vascular injury, whereas preprocedural planning with CTA of the access vessels may reduce the risk of vascular injury. Importantly, most access-related vascular injuries may be treated by percutaneous techniques with similar clinical outcomes to patients without vascular injuries.

AB - Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365 patients underwent TAVR and 333 patients (94%) were treated by true percutaneous transfemoral approach. Of this latter group, 83 patients (25%) had an access-related vascular injury that was managed by the use of a covered self-expanding stent (n = 49), balloon angioplasty (n = 33), or by surgical intervention (n = 1). In 16 patients (5%), the vascular injury was classified as a major vascular complication. Absence of a preprocedural computed tomography angiography (CTA) of the iliofemoral arteries (OR 2.04, p = 0.007) and female gender (OR 2.18, p = 0.004) were independent predictors of the need for access-related vascular intervention. In addition, a high sheath/common femoral artery ratio as measured on preoperative CTA was associated with a higher rate of post-TAVR vascular intervention. The radiation dose, iodine contrast volume, transfusion need, length of hospitalization, and 30-day mortality were not significantly different between patients with versus without access-related vascular intervention. In conclusion, access-related vascular intervention in patients who underwent transfemoral-TAVR is not uncommon. Female gender and a high sheath/common femoral artery ratio are risk factors for access-related vascular injury, whereas preprocedural planning with CTA of the access vessels may reduce the risk of vascular injury. Importantly, most access-related vascular injuries may be treated by percutaneous techniques with similar clinical outcomes to patients without vascular injuries.

KW - Journal Article

U2 - 10.1016/j.amjcard.2016.07.045

DO - 10.1016/j.amjcard.2016.07.045

M3 - Journal article

C2 - 27638098

VL - 118

SP - 1244

EP - 1250

JO - Am. J. Cardiol.

JF - Am. J. Cardiol.

SN - 0002-9149

IS - 8

ER -

ID: 177534324