December 28, 2015Catheterization and Cardiovascular Interventions
Surgical cut‐down or percutaneous access—which is best for less vascular access complications in transfemoral TAVI?
Why the study?
Does complete percutaneous access compared to surgical cut-down reduce vascular access and bleeding complications in patients undergoing transfemoral TAVI?
Population
334 consecutive patients undergoing transfemoral transcatheter aortic valve implantation in a real world-all…
Comparison
Complete percutaneous access for transfemoral TAVI vs Surgical cut-down access for transfemoral TAVI
Design
Cohort
Follow-up
In-hospital
Authors
Discussion
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Member takes
Implication
May support surgical cut-down to minimize access complications in TAVI; leaves open need for randomized confirmation.
Structured PICO
Does complete percutaneous access compared to surgical cut-down reduce vascular access and bleeding complications in patients undergoing transfemoral TAVI?
P
Population
334 consecutive patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) in a real world-all comers setting, mean age 81.4, intermediate to high surgical risk (logistic EuroSCORE 17.8%).
I
Intervention
Complete percutaneous access for transfemoral TAVI
C
Comparator
Surgical cut-down access for transfemoral TAVI
O
Outcome
Vascular access site complications and bleeding complications according to VARC-2 criteriasafety
Surgical cut-down for transfemoral TAVI may provide more controlled access with fewer overall access and bleeding complications compared to a complete percutaneous approach, though major complications do not differ significantly.
Cite This Study
Spitzer et al. (2015) studied this question.