Key result
Alternative access routes for TAVR achieve high procedural success when transfemoral access is unsuitable.
Why the study?
Alternative access routes for TAVR are necessary for patients with unfavorable iliofemoral anatomy, but comprehensive data comparing these approaches are limited.
Comprehensive review outlines alternative access strategies for transcatheter aortic valve replacement, indicating viable treatment pathways for patients with unfavorable anatomy.
Transfemoral is the most widely used and remains the preferred approach to perform Transcatheter aortic valve replacement (TAVR) in the vast majority of patients because of its superior clinical outcome. However, alternative access remains necessary in patients with unfavorable iliofemoral anatomy and includes peripheral strategies such as transcarotid, transaxillary, and transcaval approaches. Transcaval access offers a feasible option for patients without suitable arterial access and has shown high procedural success in contemporary studies. We hereby provide a comprehensive review on alternative access for TAVR, discussing the relevant data, providing the pros and cons of each access route.
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Qintar et al. (2026) conducted a review in Patients requiring TAVR with unfavorable iliofemoral anatomy. Alternative access for TAVR (transcarotid, transaxillary, transcaval) vs. Transfemoral access was evaluated. Alternative access routes for TAVR, including transcarotid, transaxillary, and transcaval approaches, offer feasible options with high procedural success for patients lacking suitable arterial access.
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