Brachial artery access for transcatheter aortic valve implantation

Topalo, Robert; Hájek, Petr; Vik, Karel; Adlová, Radka; Horn, Milan; Veselka, Josef

doi:10.5114/aic.2021.104782

Cited by 2 publications

(1 citation statement)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Topalo R. et al performed another case of TBr-TAVI with CoreValve Evolut R 34 mm (Medtronic, Minneapolis, MN, USA) due to extreme tortuosity of both pelvic arteries [12].…”

Section: Discussionmentioning

confidence: 99%

Trans-Brachial TAVI in a Patient with Aortic Isthmus Stenosis: A Case Report

Saad,

Elhakim,

Rusch

et al. 2024

JCM

View full text Add to dashboard Cite

Background: TAVI indications expand not only to low-risk patients but also to patients with a more complex anatomy and comorbidities. Transfemoral retrograde access is recognized as the first preferred approach according to the current guidelines. However, this approach is not suitable in up to 10–15% of patients, for whom an alternative non-femoral access route is required. Case Presentation: An 83-year-old male patient with known aortic isthmus stenosis presented with severe symptomatic aortic stenosis. Computed tomography revealed a subtotal isthmus stenosis, directly after left subclavian artery origin, with many collaterals extending toward the axillary and subclavian arteries. Duplex ultrasound verified the proximal diameter of the left brachial artery to be 5.5 mm. A successful surgical cutdown trans-brachial TAVI with an Evolut prosthetic valve with a size of 29 mm was performed. On the fourth postoperative day, the patient was discharged, and the three-month follow-up was uneventful. Conclusion: In patients with aortic isthmus stenosis, the brachial artery could be a feasible alternative, as a less invasive access site, which can be determined after careful assessment of the vessel diameter. More data are required to evaluate the safety and efficacy of this access route and to achieve more technical improvements to increase operator familiarity with it.

show abstract

“…Topalo R. et al performed another case of TBr-TAVI with CoreValve Evolut R 34 mm (Medtronic, Minneapolis, MN, USA) due to extreme tortuosity of both pelvic arteries [12].…”

Section: Discussionmentioning

confidence: 99%

Trans-Brachial TAVI in a Patient with Aortic Isthmus Stenosis: A Case Report

Saad,

Elhakim,

Rusch

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

Alternative access in transcatheter aortic valve replacement—an updated focused review

Abdelnour,

Patel,

Patel

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Aortic Stenosis (AS) is a common condition with an estimated pooled prevalence of all AS in the elderly population at around 12.4%, with that of severe AS estimated to be around 3.4%. In the past, surgical aortic valve replacement was the primary treatment option for severe AS for decades. However, with the compelling evidence on the safety and efficacy of transcatheter aortic valve replacement (TAVR), it has become the gold standard treatment option for many patients with symptomatic severe AS. Transfemoral access has been the preferred method for transcatheter heart valve delivery. However, the prevalent use of TAVR on a diverse patient profile with different risk factors, such as peripheral artery disease, precluded the possibility of a transfemoral approach despite the improvement of valves and delivery systems technology. Therefore, alternative TAVR approaches have gained increasing utility in cases where transfemoral access is unfavorable. We review the journey, evolution, and techniques for different approaches of percutaneous TAVR, including transfemoral, transcarotid, transsubclavian/transaxillary, and transcaval approaches, in addition to the traditional “surgical” transaortic and transapical accesses. Consolidating these data highlights each approach's practicality and limitations, providing additional grounding for case-by-case utilization and future clinical research.

show abstract

Brachial artery access for transcatheter aortic valve implantation

Cited by 2 publications

References 1 publication

Trans-Brachial TAVI in a Patient with Aortic Isthmus Stenosis: A Case Report

Trans-Brachial TAVI in a Patient with Aortic Isthmus Stenosis: A Case Report

Alternative access in transcatheter aortic valve replacement—an updated focused review

Contact Info

Product

Resources

About