Standardized Measurement of Femoral Artery Depth by Computed Tomography to Predict Vascular Complications After Transcatheter Aortic Valve Implantation

Durand, Éric; Penso, M.; Hemery, Thibaut; Levesque, Thomas; Moles, G.; Tron, Christophe; Bettinger, Nicolas; Wong, Stephanie; Dacher, Jean‐Nicolas; Eltchaninoff, Hélène

doi:10.1016/j.amjcard.2020.12.089

Cited by 10 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fifteen studies (65.2%) evaluated iliofemoral tortuosity for predicting vascular complications (Table ). Vessel tortuosity was assessed semi‐quantitatively by subjectively grading the severity of tortuosity in 11 (73.3%) studies 15,17,19–24,29,30,32 . Vessel tortuosity was measured objectively using quantitative methods in 4 (26.7%) studies by calculating iliofemoral tortuosity score ([true centreline vessel length/ideal vessel length) − 1) × 100]), 34,35 maximal degree of angulation, 18,35 sum of all angles 10 and degrees of angulation per centimeter of a vessel 27 …”

Section: Resultsmentioning

confidence: 99%

“…Vessel tortuosity was assessed semi-quantitatively by subjectively grading the severity of tortuosity in 11 (73.3%) studies. 15,17,[19][20][21][22][23][24]29,30,32 Vessel tortuosity was measured objectively using quantitative methods in 4 (26.7%) studies by calculating iliofemoral tortuosity score ([true centreline vessel length/ ideal vessel length) − 1) × 100]), 34,35 maximal degree of angulation, 18,35 sum of all angles 10 and degrees of angulation per centimeter of a vessel. 27 Four studies (26.7%) identified a significant association between the extent of vessel tortuosity and vascular complications.…”

Section: Vessel Tortuositymentioning

confidence: 99%

“…27 One study showed that greater CFA depth was an independent predictor of the need for a stent-graft after TF-TAVI [hazard ratio (HR): 1.02 (CI: 1.00-1.04), p = 0.048]. 30 The CFA depth that best predicted the need for a stent-graft was 54 mm (Sensitivity 63.3%, Specificity 40.9%), with area under curve (AUC) of 0.61 suggesting relatively poor predictive accuracy. unknown, Sensitivity and Specificity not reported).…”

Section: Vessel Dimensions and Depthmentioning

confidence: 99%

See 2 more Smart Citations

Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: A systematic review

Androshchuk,

Chehab,

Prendergast

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

BackgroundVascular complications after percutaneous transfemoral transcatheter aortic valve implantation (TAVI) are associated with adverse clinical outcomes and remain a significant challenge.AimsThe purpose of this review is to synthesize the existing evidence regarding the iliofemoral artery features predictive of vascular complications after TAVI on pre‐procedural contrast‐enhanced multidetector computed tomography (MDCT).MethodsA systematic search was performed in Embase and Medline (Pubmed) databases. Studies of patients undergoing transfemoral TAVI with MDCT were included. Studies with only valve‐in‐valve TAVI, planned surgical intervention and those using fluoroscopic assessment were excluded. Data on study cohort, procedural characteristics and significant predictors of vascular complications were extracted.ResultsWe identified 23 original studies involving 8697 patients who underwent TAVI between 2006 and 2020. Of all patients, 8514 (97.9%) underwent percutaneous transfemoral‐TAVI, of which 8068 (94.8%) had contrast‐enhanced MDCT. The incidence of major vascular complications was 6.7 ± 4.1% and minor vascular complications 26.1 ± 7.8%. Significant independent predictors of major and minor complications related to vessel dimensions were common femoral artery depth (>54 mm), sheath‐to‐iliofemoral artery diameter ratio (>0.91–1.19), sheath‐to‐femoral artery diameter ratio (>1.03–1.45) and sheath‐to‐femoral artery area ratio (>1.35). Substantial iliofemoral vessel tortuosity predicted 2–5‐fold higher vascular risk. Significant iliofemoral calcification predicted 2–5‐fold higher risk. The iliac morphology score was the only hybrid scoring system with predictive value.ConclusionsIndependent iliofemoral predictors of access‐site complications in TAVI were related to vessel size, depth, calcification and tortuosity. These should be considered when planning transfemoral TAVI and in the design of future risk prediction models.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Vessel Tortuositymentioning

confidence: 99%

Section: Vessel Dimensions and Depthmentioning

confidence: 99%

See 1 more Smart Citation

Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: A systematic review

Androshchuk,

Chehab,

Prendergast

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Ilio-femoral calcification was appraised according to Okuyama et al, awarding 2 points in case of moderate or severe calcification, 1 point in case of mild calcification, and 0 points in case of no calcification 36 . Access size ≤ 6.0 mm yielded a 1 point, whereas > 6.0 mm yielded 0 points 37 . Finally, planned aortic, apical, carotid, caval or subclavian access yielded 2 points, planned axillary access yielded 1 point, and planned femoral access yielded 0 points.…”

Section: Methodsmentioning

confidence: 96%

TAVI-CT score to evaluate the anatomic risk in patients undergoing transcatheter aortic valve implantation

Corcione

Morello

Ferraro³

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Transcatheter aortic valve implantation (TAVI) requires thorough preprocedural planning with non-invasive imaging, including computed tomography (CT). The plethora of details obtained with thoraco-abdominal CT represents a challenge for accurate and synthetic decision-making. We devised and tested a comprehensive score suitable to summarize CT exams when planning TAVI. An original comprehensive scoring system (TAVI-CT score) was devised, including details on cardiac, aortic, iliac and femoral artery features. The score was applied to a prospectively collected series of patients undergoing TAVI at our institution, driving decision making on access and prosthesis choice. Different TAVI-CT score groups were compared in terms of procedural success, acute complications, and early clinical outcomes. We included a total of 200 undergoing TAVI between February 2020 and May 2021, with 74 (37.0%) having a low (0–2) TAVI-CT score, 50 (25.0%) having a moderate (3) TAVI-CT score, and 76 (38.0%) having a high (≥ 4) TAVI-CT score. Male gender was the only non-CT variable significantly associated with the TAVI-CT score (p = 0.001). As expected, access choice differed significantly across TAVI-CT scores (p = 0.009), as was device choice, with Portico more favored and Allegra less favored in the highest TAVI-CT score group (p = 0.036). Acute outcomes were similar in the 3 groups, including device and procedural success rates (respectively p = 0.717 and p = 1). One-month follow-up showed similar rates of death, myocardial infarction, stroke, and bleeding, as well as of a composite safety endpoint (all p > 0.05). However, vascular complications were significantly more common in the highest TAVI-CT score group (p = 0.041). The TAVI-CT score is a simple scoring system that could be routinely applied to CT imaging for TAVI planning, if the present hypothesis-generating findings are confirmed in larger prospective studies.

show abstract

“…14 CFA depth was determined as the distance between the skin and the center point of the CFA, as described previously. 18 The primary endpoint of this study was MANTA-related VC at 30 days after TAVI. VC was defined based on the Valve Academic Research Consortium 3 (VARC-3) criteria, 19 and MANTA-related VC was defined as the access site-related VC that occurred because of MANTA usage.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound-Guided Versus Conventional MANTA Vascular Closure Device Deployment After Transcatheter Aortic Valve Implantation

Miyashita

Moriyama

Dahlbacka

et al. 2022

The American Journal of Cardiology

View full text Add to dashboard Cite

Standardized Measurement of Femoral Artery Depth by Computed Tomography to Predict Vascular Complications After Transcatheter Aortic Valve Implantation

Cited by 10 publications

References 28 publications

Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: A systematic review

Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: A systematic review

TAVI-CT score to evaluate the anatomic risk in patients undergoing transcatheter aortic valve implantation

Ultrasound-Guided Versus Conventional MANTA Vascular Closure Device Deployment After Transcatheter Aortic Valve Implantation

Contact Info

Product

Resources

About