Key result
Left carotid TAVI succeeds without neurologic complications in severe AS with severe peripheral arteriopathy.
Why the study?
TAVI through peripheral arterial access is often complicated by concomitant arteriopathy.
Is transcatheter aortic valve implantation via the carotid artery feasible and safe in a patient with severe aortic stenosis and unsuitable peripheral access?
Case Report (n=1)
No
Is transcatheter aortic valve implantation via the carotid artery feasible and safe in a patient with severe aortic stenosis and unsuitable peripheral access?
TAVI via the carotid artery is a feasible alternative access route for patients with severe aortic stenosis and unsuitable iliofemoral or direct aortic access.
Answers are grounded in this paper and cite their sources.
Carotid access may be feasible for TAVI in unsuitable peripheral anatomy; leaves open need for prospective safety data.
Transcatheter aortic valve implantation (TAVI) through a peripheral arterial access is often complicated by concomitant arteriopathy. We describe here the first successful case of TAVI through the carotid artery in Japan. The patient was an 83-year-old woman with severe aortic stenosis (AS). Preoperative computed tomography (CT) revealed a shaggy distal aortic arch and left subclavian artery ostium, along with severely calcified bilateral iliofemoral arteries. Trans-apical and direct aortic approaches were abandoned because of frailty. Following the thorough cerebrovascular assessment, the left common carotid artery was selected for arterial access and a CoreValve transcatheter aortic valve was successfully implanted without neurologic complications.
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Misumi et al. (2018) conducted a case report in Severe aortic stenosis (n=1). Transcatheter aortic valve implantation via left carotid artery was evaluated on Procedural success and absence of neurologic complications. Transcatheter aortic valve implantation via the left carotid artery was successfully performed without neurologic complications in an 83-year-old woman with severe aortic stenosis and severe peripheral arteriopathy.
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