1. Inicio
  2. Publicaciones
  3. Puncture Versus Surgical Cutdown Complications of Transfemoral Aortic Valve Implantation (from the Spanish TAVI Registry)

Puncture Versus Surgical Cutdown Complications of Transfemoral Aortic Valve Implantation (from the Spanish TAVI Registry)

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Hernandez-Enriquez, M
  • Andrea, R
  • Brugaletta, S
  • Jimenez-Quevedo, P
  • Hernandez-Garcia, JM
  • Trillo, R
  • Larman, M
  • Fernandez-Aviles, F
  • Vazquez-Gonzalez, N
  • Iniguez, A
  • Zueco, J
  • Ruiz-Salmeron, R
  • del Valle, R
  • Molina, E
  • del Blanco, BG
  • Berenguer, A
  • Valdes, M
  • Moreno, R
  • Urbano-Carrillo, C
  • Hernandez-Antolin, R
  • Gimeno, F
  • Cequier, A
  • Cruz, I
  • Lopez-Minguez, JR
  • Aramendi, JI
  • Sanchez, A
  • Goicolea, J
  • Albarran, A
  • Diaz, JF
  • Navarro, F
  • Moreu, J
  • Morist, A
  • Fernandez-Nofrerias, E
  • Fernandez-Vazquez, F
  • Mainar, V
  • Mari, B
  • Saenz, A
  • Alfonso, F
  • Diarte, JA
  • Sancho, M
  • Lezaun, R
  • Arzamendi, D
  • Sabate, M

Abstract

Vascular complications in transcatheter aortic valve implantation using transfemoral approach are related to higher mortality. Complete percutaneous approach is currently the preferred technique for vascular access. However, some centers still perform surgical cutdown. Our purpose was to determine complications related to vascular access technique in the population of the Spanish TAVI National Registry. From January 2010 to July 2015, 3,046 patients were included in this Registry. Of them, 2,465 underwent transfemoral approach and were treated with either surgical cutdown and closure (cutdown group, n = 632) or percutaneous approach (puncture group, n = 1,833). Valve Academic Research Consortium-2 definitions were used to assess vascular and bleeding complications. Propensity matching resulted in 615 matched pairs. Overall, 30-day vascular complications were significantly higher in the puncture group (109 [18%] vs 42 [6.9%]; relative risk [RR] 2.60; 95% confidence interval [CI] 1.85 to 3.64, p <0.001) due mostly by minor vascular events (89 [15%] vs 25 [4.1%], RR 3.56, 95% CI 2.32 to 5.47, p <0.001). Bleeding rates were lower in the puncture group (18 [3%] vs 40 [6.6%], RR 0.45, 95% CI 0.26 to 0.78, p = 0.003) mainly driven by major bleeding (9 [1.5%] vs 21 [3.4%], RR 0.43, 95% CI 0.20 to 0.93, p = 0.03). At a mean follow-up of 323 days, complication rates remained significantly different between groups (minor vascular complications 90 [15%] vs 31 [5.1%], hazard ratio 2.99, 95% CI 1.99 to 4.50, p <0.001 and major bleeding 10 [1.6%] vs 21 [3.4%], hazard ratio 0.47, 95% CI 0.22 to 1.0, p = 0.04, puncture versus cutdown group, respectively). In conclusion, percutaneous approach yielded higher rates of minor vascular complications but lower rates of major bleeding compared with the surgical cutdown, both at 30-day and at mid-term follow-up in our population. (C) 2016 Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0002-9149, 1879-1913

AMERICAN JOURNAL OF CARDIOLOGY  EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
578-584
PubMed:
27378142
Factor de Impacto:
2,089 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 19

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Campos de Estudio

Proyectos y Estudios Clínicos

ESTUDIO DE BIOMARCADORES DE FUNCIÓN PLAQUETARIA EN ANGIOPLASTIA PRIMARIA RELACIONADOS CON EL TIPO DE STENT Y EL EFECTO DE LOS FÁRMACOS ANTIPLAQUETARIOS

Investigador Principal: ANTONIO MOSCARDÓ MARTÍNEZ

2015_0403_CRP_MOSCARDO . SOCIEDAD VALENCIANA DE CARDIOLOGIA . 2015

BALÓN LIBERADOR DE PACLITAXEL TRAS STENT CONVENCIONAL VS STENT LIBERADOR DE FÁRMACOS EN EL INFARTO AGUDO CON ELEVACIÓN DE ST (ESTUDIO PEBSI-2).

Investigador Principal: LUIS ANDRÉS LALAGUNA

PEBSI-2 . 2016

Compartir