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Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries
BACKGROUND: Small femoral arteries have been associated with a higher risk of vascular complications in transfemoral transcatheter aortic valve replacement (TAVR). We investigated the feasibility and safety of TAVR in patients with small femoral arteries. METHODS: In this observational study, we inc...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513271/ https://www.ncbi.nlm.nih.gov/pubmed/34642241 http://dx.doi.org/10.1136/openhrt-2021-001703 |
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author | Glaser, Natalie O'Sullivan, Crochan J. Saleh, Nawzad Verouhis, Dinos Settergren, Magnus Linder, Rickard Rück, Andreas |
author_facet | Glaser, Natalie O'Sullivan, Crochan J. Saleh, Nawzad Verouhis, Dinos Settergren, Magnus Linder, Rickard Rück, Andreas |
author_sort | Glaser, Natalie |
collection | PubMed |
description | BACKGROUND: Small femoral arteries have been associated with a higher risk of vascular complications in transfemoral transcatheter aortic valve replacement (TAVR). We investigated the feasibility and safety of TAVR in patients with small femoral arteries. METHODS: In this observational study, we included 82 patients who underwent transfemoral TAVR with the ACURATE neo system using the expandable 14F iSleeve sheath between 2018 and 2019 at Karolinska University Hospital, Sweden. Of these, 41 patients had a minimal femoral artery diameter of ≥5.5 mm (mean 6.5, range 5.5–9.2), and 41 patients had a minimal femoral artery diameter <5.5 mm (mean 4.9, range 3.9–5.4). RESULTS: There was no significant difference in major vascular and bleeding complications between the small femoral artery group (7%) and the normal femoral artery group (2%) (p=0.62). The total of major and minor vascular complications did not differ significantly according to femoral artery size (17% vs 5%) (p=0.16). The iSleeve sheath was not correlated with any of the complications. The use of the iSleeve sheath was unsuccessful in four patients (5%), of which one patient had a small femoral artery diameter. CONCLUSION: Transfemoral TAVR with the ACURATE neo system using the iSleeve sheath is a promising method for patients with small femoral arteries even though we found a trend towards higher rates of complications in these patients. The use of expandable sheaths may expand the spectrum of patients that can be treated with transfemoral TAVR, and thus may improve the prognosis in patients with severe aortic valve stenosis. |
format | Online Article Text |
id | pubmed-8513271 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-85132712021-10-27 Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries Glaser, Natalie O'Sullivan, Crochan J. Saleh, Nawzad Verouhis, Dinos Settergren, Magnus Linder, Rickard Rück, Andreas Open Heart Interventional Cardiology BACKGROUND: Small femoral arteries have been associated with a higher risk of vascular complications in transfemoral transcatheter aortic valve replacement (TAVR). We investigated the feasibility and safety of TAVR in patients with small femoral arteries. METHODS: In this observational study, we included 82 patients who underwent transfemoral TAVR with the ACURATE neo system using the expandable 14F iSleeve sheath between 2018 and 2019 at Karolinska University Hospital, Sweden. Of these, 41 patients had a minimal femoral artery diameter of ≥5.5 mm (mean 6.5, range 5.5–9.2), and 41 patients had a minimal femoral artery diameter <5.5 mm (mean 4.9, range 3.9–5.4). RESULTS: There was no significant difference in major vascular and bleeding complications between the small femoral artery group (7%) and the normal femoral artery group (2%) (p=0.62). The total of major and minor vascular complications did not differ significantly according to femoral artery size (17% vs 5%) (p=0.16). The iSleeve sheath was not correlated with any of the complications. The use of the iSleeve sheath was unsuccessful in four patients (5%), of which one patient had a small femoral artery diameter. CONCLUSION: Transfemoral TAVR with the ACURATE neo system using the iSleeve sheath is a promising method for patients with small femoral arteries even though we found a trend towards higher rates of complications in these patients. The use of expandable sheaths may expand the spectrum of patients that can be treated with transfemoral TAVR, and thus may improve the prognosis in patients with severe aortic valve stenosis. BMJ Publishing Group 2021-10-12 /pmc/articles/PMC8513271/ /pubmed/34642241 http://dx.doi.org/10.1136/openhrt-2021-001703 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Interventional Cardiology Glaser, Natalie O'Sullivan, Crochan J. Saleh, Nawzad Verouhis, Dinos Settergren, Magnus Linder, Rickard Rück, Andreas Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title | Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title_full | Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title_fullStr | Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title_full_unstemmed | Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title_short | Transcatheter aortic valve replacement using the iSleeve expandable sheath in small femoral arteries |
title_sort | transcatheter aortic valve replacement using the isleeve expandable sheath in small femoral arteries |
topic | Interventional Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513271/ https://www.ncbi.nlm.nih.gov/pubmed/34642241 http://dx.doi.org/10.1136/openhrt-2021-001703 |
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