July 19, 2013Catheterization and Cardiovascular Interventions
Complete percutaneous approach for arterial access in transfemoral transcatheter aortic valve replacement: A comparison with surgical cut‐down and closure
Key result
A complete percutaneous approach for TAVR had similar major vascular complications to surgical cut-down, but higher stenosis/dissection (7.1% vs 0.7%) and lower wound infections (0.7% vs 6.7%).
Why the study?
Does a complete percutaneous approach improve immediate safety and clinical outcomes compared to surgical cut-down in patients undergoing transfemoral TAVR?
Population
274 patients undergoing transfemoral transcatheter aortic valve replacement using the Edward Sapien heart…
Comparison
Complete percutaneous approach using a… vs Surgical cut-down and repair for arterial access…
Design
Cohort
Follow-up
In-hospital
Authors
Discussion
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Implication
May reduce TAVR access-site infections but increase vascular complications; hypothesis-generating and requires larger randomized confirmation.
Study Design
Type
Observational (n=274)
Structured PICO
Does a complete percutaneous approach improve immediate safety and clinical outcomes compared to surgical cut-down in patients undergoing transfemoral TAVR?
P
Population
274 patients who underwent transfemoral TAVR using the Edward Sapien heart valve.
E
Exposure
Complete percutaneous approach using a 'pre-closure' technique for arterial access and closure
C
Comparator
Surgical cut-down and repair for arterial access and closure
O
Outcome
Immediate vascular access/closure success, associated complications, and clinical outcomessafety
The percutaneous approach for transfemoral TAVR is a feasible alternative to surgical cut-down, offering reduced infection and bleeding risks and shorter hospital stays, though with an increased risk of access site stenosis or dissection.
Cite This Study
Nakamura et al. (2013) conducted an observational in Transfemoral transcatheter aortic valve replacement (TAVR) (n=274). Complete percutaneous approach using a pre-closure technique vs. Surgical cut-down/repair was evaluated on Immediate vascular access/closure success, associated complications and clinical outcomes. A complete percutaneous approach for TAVR had similar major vascular complications to surgical cut-down, but higher stenosis/dissection (7.1% vs 0.7%) and lower wound infections (0.7% vs 6.7%).