Long term follow‐up after balloon expandable covered stents implantation for management of transcatheter aortic valve replacement related vascular access complications

OBJECTIVES: To report the experience of a high‐volume center with balloon‐expandable (BE) stents implantation to manage vascular complications after transcatheter aortic valve replacement (TAVR). BACKGROUND: Despite increased operator experience and better devices, vascular complications after TAVR are still a major issue and covered stent implantation is often required. METHODS: We retrospectively collected baseline and procedural data about 78 consecutive patients who underwent BE stent implantation to manage a vascular complication after transfemoral TAVR. Primary endpoints were technical success, incidence of new‐onset claudication and need for vascular interventions during long‐term follow‐up. Secondary endpoints included length of hospitalization, in‐hospital and 30‐day mortality, and major postoperative complications. RESULTS: BE stents implantation to manage vascular complications after TAVR was successfully performed in 96.2% of the cases, with bailout surgery required in two cases. One patient suffered in‐hospital death. Predischarge Doppler Ultrasound revealed no cases of in‐stent occlusion or fracture. At a median follow‐up of 429 days (interquartile range, 89−994 days), no cases of symptomatic leg ischemia were reported and only one patient experienced new‐onset claudication. CONCLUSIONS: Our experience showed good periprocedural and long‐term results of BE covered stent implantation to manage vascular complication after TAVR. Their great radial outward force may guarantee effective hemostasis without necessarily being associated with stent deformation/fracture resulting in restenosis or further interventions. More research is needed to define the role of BE covered stents in this setting.