A new technique for vascular access management in transcatheter aortic valve implantation

Abstract

Using crossover balloon inflation as an adjunct to Prostar closure may be helpful for managing TAVI vascular access sites.

Predictors of moderate‐to‐severe paravalvular aortic regurgitation immediately after corevalve implantation and the impact of postdilatation

“…The risk of high implantation is embolization of the CoreValve prosthesis which occurred in four patients (5.1%) in our series. Notably, in patients with AR as a result of valve malposition, postdilatation is not a useful treatment option and other methods such as ''valve-in-valve'' implantation or valve snaring with a gooseneck snare might be considered [9,11,14,[25][26][27][28].…”

Routine Endovascular Treatment With a Stent Graft for Access-Site and Access-Related Vascular Injury in Transfemoral Transcatheter Aortic Valve Implantation

“…Possible treatment options range from conservative treatment with manual compression with or without the use of protamine, endovascular approaches with use of balloon occlusion, or implantation of covered stent grafts to open surgical management. 7,8 Although surgical management of vascular complications after percutaneous femoral procedures can be performed safely, 9 nonsurgical treatment options are desirable because these patients are usually old, frail, and have a high operative risk.…”

Vascular complications associated with transcatheter aortic valve replacement

“…20 Another adjunctive means of hemostasis involves deploying a guidewire from the contralateral femoral artery across the TAVR sheath access site before insertion of the TAVR sheath and then performing the crossover balloon occlusion technique (CBOT). 21,22 This technique can be used selectively in higher risk patients and has been associated with a lower risk of Valve Academic Research Consortium-2 (VARC-2) major vascular and bleeding complications. 23 …”

“…This is usually manifest as a puckered appearance on DSA and is most often mild, without vascular compromise, 35 not requiring further treatment. In cases of severe stenosis with compromised distal flow, balloon dilation may help; stents are rarely required 21,22 (Figure 4). Thrombosis at the site of the arteriotomy is rare, but can occur with prolonged inflation of a crossover hemostasis balloon.…”

“…Thrombosis at the site of the arteriotomy is rare, but can occur with prolonged inflation of a crossover hemostasis balloon. Arterial thrombosis may require thrombectomy and/or balloon angioplasty to reestablish patency 21,76 (Figure 5). …”