Key result
A step-by-step guide to fully percutaneous transaxillary transcatheter aortic valve replacement is provided as an alternative for patients with severe aortic stenosis and unsuitable femoral access.
This review provides a step-by-step guide for performing fully percutaneous transaxillary TAVR, offering an alternative access route for patients with severe iliofemoral disease.
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May facilitate transaxillary TAVR when femoral access is unsuitable; leaves open prospective validation of outcomes.
Transcatheter aortic valve replacement (TAVR) is now established as a viable therapy for the treatment of severe aortic stenosis. Though femoral access is used for the majority of cases today, this approach may be limited in cases of insufficient vessel caliber, tortuosity or severe iliofemoral disease. For such scenarios, a transaxillary (TAx) approach is appealing as this vessel appears to be far less frequently affected by atherosclerotic disease, even in the presence of significant iliofemoral disease. Though surgical cut-down has been the traditional method for the TAx approach, there has been a growing clinical experience with successful percutaneous transaxillary access in the setting of TAVR and mechanical circulatory support devices. In this review, we offer a step-by-step guide to TAx TAVR.
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Mathur et al. (2017) conducted a review in Severe aortic stenosis. Percutaneous transaxillary transcatheter aortic valve replacement (TAx TAVR) was evaluated. A step-by-step guide to fully percutaneous transaxillary transcatheter aortic valve replacement is provided as an alternative for patients with severe aortic stenosis and unsuitable femoral access.
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