Femoro-femoral bypass serves as a viable, less invasive bailout strategy for acute limb ischemia complicating TAVI in high-risk patients.
May support femoro-femoral bypass as bailout for TAVI vascular complications; hypothesis-generating and requires prospective validation.
A 94-year-old woman underwent transcatheter aortic valve implantation (TAVI) for treatment of severe aortic stenosis (AS). Final angiography showed the right external iliac artery occlusion due to vascular injury related to a large-diameter introducer sheath. Although we performed endovascular therapy, no guidewires could cross the culprit lesion because the intima had frapped and occluded the vessel lumen. Therefore, we performed femoro-femoral bypass for bailout of acute limb ischemia. Femoro-femoral bypass is a less invasive, shorter operation time and therefore a reasonable strategy as an urgent bailout for vascular complications during TAVI in super-aged or higher-risk surgical patients with severe AS.
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Omote et al. (2025) studied this question.
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