Key result
Minimalist radial and axillary approach safely manages transaxillary hemostasis during high-risk TAVI.
Why the study?
The transaxillary route is a valid alternative access for percutaneous interventions in obstructive peripheral disease, but widespread use is limited by a less manageable haemostasis procedure.
Case Report (n=1)
A double-arm approach (radial and axillary) can be a successful alternative for TAVI in patients with severe peripheral artery disease where transfemoral access is not possible.
BACKGROUND: Transaxillary route for structural and coronary percutaneous interventions represents a valid alternative access in patients with obstructive peripheral disease. Nevertheless, its widespread use is limited by a less manageable haemostasis procedure. CASE SUMMARY: In this case, we describe a minimalistic high-risk transcatheter aortic valve implantation (TAVI) procedure (TAVI Score 6.42%) conducted with a double arm approach (radial and axillary accesses) in an 88-year-old patient with severe aortic stenosis and multiple co-morbidities preventing both surgical (Society of Thoracic Surgeons mortality 7.9%) and percutaneous transfemoral approach (extensive peripheral artery disease). We also described the successful management of a complicated transaxillary haemostasis with this technique. DISCUSSION: In our cases, a minimalist double-arm approach was successfully used for TAVI procedure as an alternative to transfemoral approach assuring effective and safe management of vascular access haemostasis.
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Trani et al. (2020) conducted a case report in Severe aortic stenosis (n=1). Minimalistic high-risk transcatheter aortic valve implantation (TAVI) with a double arm approach (radial and axillary accesses) was evaluated on Successful management of transaxillary haemostasis. A minimalist double-arm approach (radial and axillary accesses) was successfully used for a high-risk TAVI procedure in an 88-year-old patient, allowing safe management of transaxillary haemostasis.
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