SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

Antonio Giovanni Cammardella; Marco Russo; Michele Di Mauro; Claudia Romagnoni; Fabrizio Ceresa; Francesco Patanè; Guido Gelpi; Francesco Pollari; Fabio Barili; Alessandro Parolari; Federico Ranocchi; Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH)

doi:10.3390/jcm13154471

SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

Antonio Giovanni Cammardella^*, Marco Russo, Michele Di Mauro, Claudia Romagnoni, Fabrizio Ceresa, Francesco Patanè, Guido Gelpi, Francesco Pollari, Fabio Barili, Alessandro Parolari, Federico Ranocchi, Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p &#x003C;.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p &#x003C; 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient&#x2019;s clinical characteristics.

Original language	English
Article number	4471
Number of pages	11
Journal	Journal of Clinical Medicine
Volume	13
Issue number	15
DOIs	https://doi.org/10.3390/jcm13154471
Publication status	Published - 30 Jul 2024

Keywords

TAVI
transfemoral
vascular access
vascular closure devices (VCD)
vascular complications

Access to Document

10.3390/jcm13154471Licence: CC BY

Cite this

Cammardella, A. G., Russo, M., Di Mauro, M., Romagnoni, C., Ceresa, F., Patanè, F., Gelpi, G., Pollari, F., Barili, F., Parolari, A., Ranocchi, F., & Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH) (2024). SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study). Journal of Clinical Medicine, 13(15), Article 4471. https://doi.org/10.3390/jcm13154471

@article{3260bf117ac7495eb8bdd17824a87704,

title = "SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)",

abstract = "Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p <.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p < 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient’s clinical characteristics.",

keywords = "TAVI, transfemoral, vascular access, vascular closure devices (VCD), vascular complications",

author = "Cammardella, {Antonio Giovanni} and Marco Russo and {Di Mauro}, Michele and Claudia Romagnoni and Fabrizio Ceresa and Francesco Patan{\`e} and Guido Gelpi and Francesco Pollari and Fabio Barili and Alessandro Parolari and Federico Ranocchi and {Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH)}",

year = "2024",

month = jul,

day = "30",

doi = "10.3390/jcm13154471",

language = "English",

volume = "13",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "15",

}

Cammardella, AG, Russo, M, Di Mauro, M, Romagnoni, C, Ceresa, F, Patanè, F, Gelpi, G, Pollari, F, Barili, F, Parolari, A, Ranocchi, F & Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH) 2024, 'SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)', Journal of Clinical Medicine, vol. 13, no. 15, 4471. https://doi.org/10.3390/jcm13154471

TY - JOUR

T1 - SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

AU - Cammardella, Antonio Giovanni

AU - Russo, Marco

AU - Di Mauro, Michele

AU - Romagnoni, Claudia

AU - Ceresa, Fabrizio

AU - Patanè, Francesco

AU - Gelpi, Guido

AU - Pollari, Francesco

AU - Barili, Fabio

AU - Parolari, Alessandro

AU - Ranocchi, Federico

AU - Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH)

PY - 2024/7/30

Y1 - 2024/7/30

N2 - Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p <.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p < 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient’s clinical characteristics.

AB - Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p <.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p < 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient’s clinical characteristics.

KW - TAVI

KW - transfemoral

KW - vascular access

KW - vascular closure devices (VCD)

KW - vascular complications

U2 - 10.3390/jcm13154471

DO - 10.3390/jcm13154471

M3 - Article

SN - 2077-0383

VL - 13

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 15

M1 - 4471

ER -

SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

Abstract

Keywords

Access to Document

Fingerprint

Cite this