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 - Patane, 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)
N1 - Pollari: Cardiac Surgery, Klinikum Nürnberg-Paracelsus Medical University, 90471 Nuremberg, German
PY - 2024/8
Y1 - 2024/8
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
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001287825900001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.3390/jcm13154471
DO - 10.3390/jcm13154471
M3 - Original Article
C2 - 39124736
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 15
M1 - 4471
ER -