Cargando…

Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series

BACKGROUND: The transfemoral (TF) approach drives most of the advantages of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement. Alternative accesses for TAVI are associated with higher complication rates, but are still considered in ∼5% of cases due to peripheral a...

Descripción completa

Detalles Bibliográficos
Autores principales: Quagliana, Angelo, Montarello, Nicholas J, Vanhaverbeke, Maarten, Willemen, Yannick, Campens, Laurence, Sondergaard, Lars, De Backer, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369203/
https://www.ncbi.nlm.nih.gov/pubmed/37501711
http://dx.doi.org/10.1093/ehjcr/ytad310
_version_ 1785077706226925568
author Quagliana, Angelo
Montarello, Nicholas J
Vanhaverbeke, Maarten
Willemen, Yannick
Campens, Laurence
Sondergaard, Lars
De Backer, Ole
author_facet Quagliana, Angelo
Montarello, Nicholas J
Vanhaverbeke, Maarten
Willemen, Yannick
Campens, Laurence
Sondergaard, Lars
De Backer, Ole
author_sort Quagliana, Angelo
collection PubMed
description BACKGROUND: The transfemoral (TF) approach drives most of the advantages of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement. Alternative accesses for TAVI are associated with higher complication rates, but are still considered in ∼5% of cases due to peripheral arterial disease (PAD). Percutaneous transluminal angioplasty can still allow TF-TAVI in selected cases with severe calcific PAD; however, ancillary techniques for calcium management are often needed. CASE SUMMARY: Orbital atherectomy was selected to facilitate TF-TAVI in two patients with different degrees and aspects of calcific PAD. Pre-procedural computed tomography analysis was key to choose the most appropriate technique for calcium management. We describe our experience with a step-by-step procedural approach to orbital atherectomy-assisted TF-TAVI. DISCUSSION: PAD is not uncommon in patients affected by severe symptomatic aortic valve stenosis. Orbital atherectomy can still allow TF-TAVI in selected cases with severe calcific PAD. A meticulous patient selection and a standardized, step-wise procedural execution are mandatory to optimize outcomes.
format Online
Article
Text
id pubmed-10369203
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-103692032023-07-27 Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series Quagliana, Angelo Montarello, Nicholas J Vanhaverbeke, Maarten Willemen, Yannick Campens, Laurence Sondergaard, Lars De Backer, Ole Eur Heart J Case Rep Case Series BACKGROUND: The transfemoral (TF) approach drives most of the advantages of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement. Alternative accesses for TAVI are associated with higher complication rates, but are still considered in ∼5% of cases due to peripheral arterial disease (PAD). Percutaneous transluminal angioplasty can still allow TF-TAVI in selected cases with severe calcific PAD; however, ancillary techniques for calcium management are often needed. CASE SUMMARY: Orbital atherectomy was selected to facilitate TF-TAVI in two patients with different degrees and aspects of calcific PAD. Pre-procedural computed tomography analysis was key to choose the most appropriate technique for calcium management. We describe our experience with a step-by-step procedural approach to orbital atherectomy-assisted TF-TAVI. DISCUSSION: PAD is not uncommon in patients affected by severe symptomatic aortic valve stenosis. Orbital atherectomy can still allow TF-TAVI in selected cases with severe calcific PAD. A meticulous patient selection and a standardized, step-wise procedural execution are mandatory to optimize outcomes. Oxford University Press 2023-07-12 /pmc/articles/PMC10369203/ /pubmed/37501711 http://dx.doi.org/10.1093/ehjcr/ytad310 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Series
Quagliana, Angelo
Montarello, Nicholas J
Vanhaverbeke, Maarten
Willemen, Yannick
Campens, Laurence
Sondergaard, Lars
De Backer, Ole
Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title_full Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title_fullStr Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title_full_unstemmed Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title_short Orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
title_sort orbital atherectomy to facilitate transfemoral transcatheter aortic valve implantation in patients with calcified iliofemoral arteries: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369203/
https://www.ncbi.nlm.nih.gov/pubmed/37501711
http://dx.doi.org/10.1093/ehjcr/ytad310
work_keys_str_mv AT quaglianaangelo orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT montarellonicholasj orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT vanhaverbekemaarten orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT willemenyannick orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT campenslaurence orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT sondergaardlars orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries
AT debackerole orbitalatherectomytofacilitatetransfemoraltranscatheteraorticvalveimplantationinpatientswithcalcifiediliofemoralarteriesacaseseries