A Novel Iliac Morphology Score Predicts Procedural Mortality and Major Vascular Complications in Transfemoral Aortic Valve Replacement

Blakeslee-Carter, Juliet; Dexter, David J.; Mahoney, Paul; Ahanchi, Sadie; Steerman, Samuel; Larion, Sebastian; Cain, Brandon; Panneton, Jean M.

doi:10.1016/j.avsg.2017.06.137

Cited by 18 publications

(24 citation statements)

References 16 publications

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“…Indeed, logistic regression revealed that the chance of suffering a major complication is 3.6-fold higher among women than among men. This finding is consistent with previous studies, 4,10,12,26,27 and might be based on gender-specific differences in anatomy. Our analysis shows that female patients have a significantly shorter CFA, a smaller vessel angulation at the puncture site, a shorter minimal luminal diameter, and smaller vessel perimeter and area.…”

Section: Discussionsupporting

confidence: 94%

Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Kmiec

Zerdzitzki

Schmid

et al. 2021

Thorac Cardiovasc Surg

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Background The MANTA vascular closure device (VCD) is a novel collagen plug-based VCD for large bore arteriotomies. The current literature regarding complication rates of this device is quite variable and mostly limited to relatively small case series. Methods This study is retrospective analysis of the MANTA VCD-related main access site complications according to Valve Academic Research Consortium-2 (VARC-2) criteria during the hospital stay. Particular attention was paid to the detailed analysis of multislice computed tomography with regard to the anatomy of the access vessel and the puncture site itself. Results A total of 524 patients underwent transfemoral transcatheter aortic valve implantation (TF TAVI) including the use of the MANTA device (18F) for percutaneous vascular closure. A group of 22 patients was excluded from the study due to incomplete imaging data. During the study period, we observed 28 major (5.6%) and five minor (1.0%) MANTA device-related vascular complications. There was no patient death related to these adverse events. Female gender, vessel angulation at the puncture site, and at least moderate calcification of the dorsal vessel segment were identified as independent predictors for major complications. Conclusions The MANTA device is a feasible option for vascular closure of large bore arteriotomies in patients undergoing TF TAVI or other percutaneous transfemoral interventions. Furthermore, we have identified novel predictors for device failure/complications that should be taken into account for selection of the appropriate closure device. To our knowledge, this report is one of the largest case series analyzing the use of the MANTA VCD.

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Section: Discussionsupporting

confidence: 94%

Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Kmiec

Zerdzitzki

Schmid

et al. 2021

Thorac Cardiovasc Surg

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“…Although qualitative femoral calci cation has previously been reported as a risk factor for vascular complications[6], [22], [24], this study investigated a novel quantitative method of measuring femoral plaque. Despite nding an association with necrotic core volume and VARC outcomes, we did not nd a signi cant association between the volume of calci cation and VARC composite outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have investigated demographic and procedural risk factors associated with VARC Vascular Access Site & Access-Related Complications, demonstrating that female sex [21] and sheath to femoral artery ratio (SFAR) [6] and anatomical features such as distance from common femoral artery (CFA) to skin [22] and tortuosity [23] are signi cantly associated with an increased risk of VARC vascular complications. Arterial calci cation de ned by computed tomography (CT) imaging is also a risk factor for vascular complications[6], [22], [24]. However, to date only qualitative measures of calci cation have been utilised.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation

Carande

Salim

Chase

et al. 2023

Preprint

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Purpose Vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) are common and lead to increased morbidity and mortality. Analysis of plaque at the arterial access site may improve prediction of complications. Methods We investigated the association between demographic and procedural risk factors for Valve Academic Research Consortium (VARC) vascular complications, as well as a novel method of quantifying plaque composition of the common femoral artery using computed tomography angiography plaque maps created with patient specific x-ray attenuation cut-offs. The relationship between time to haemostasis after TAVI with demographic and procedural risk factors was also investigated. Results Twenty-three vascular complications occurred in the 299 patients in the study group (7.7%). There were no demographic risk factors associated with vascular complications and no statistical difference between use of closure device (ProGlide® vs MANTA®) and vascular complications. Vascular complications after TAVI were significantly associated with sheath size (OR 1.36, 95% CI 1.08–1.76, P 0.01) and strongly associated with necrotic core volume in the common femoral artery of the procedural side (OR 17.49, 95% CI 1.21–226.60, P 0.03). The use of the ProGlide® closure device (T 2.99, P 0.004) rather than MANTA® was significantly associated with an increased time to haemostasis after TAVI. Conclusion Plaque map analysis of plaque composition of the common femoral artery by CT angiography reveals patients with greater necrotic core are at increased risk of VARC vascular complications.

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“…Parameters were as follows: minimal iliofemoral diameter, iliofemoral calcifications, and iliofemoral tortuosity. An iliac morphology score (IMS) was calculated for each patient (14). The calcification rate of iliofemoral access was graded from 0-3 (0 = no calcification; 1 = calcification < 25% of the vessel length; 2 = calcification ranging from 25% to 50%; and 3 = calcification > 50% or circumferential calcification) (15).…”

Section: Methodsmentioning

confidence: 99%

Incidence, predictors, impact, and treatment of vascular complications after transcatheter aortic valve implantation in a modern prospective cohort under real conditions

Langouet¹,

Martinez²,

Saint‐Etienne³

et al. 2020

Journal of Vascular Surgery

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Article highlightsType of research: Multicenter, prospective, nonrandomized cohort study Key findings: The incidence of vascular complications was high (26.1%) following 479 transcatheter aortic valve implantation (TAVI), but 88.8% were minor and survival was not affected. Major complications were rare. they were treated with surgery and had a significant impact on survival at 30 days (69.3%) and 1 year (59.4%) .

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A Novel Iliac Morphology Score Predicts Procedural Mortality and Major Vascular Complications in Transfemoral Aortic Valve Replacement

Cited by 18 publications

References 16 publications

Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation

Incidence, predictors, impact, and treatment of vascular complications after transcatheter aortic valve implantation in a modern prospective cohort under real conditions

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