Author + information
- S1936879815022293-b41fe52590ef8bb393cebb8b291037bfArie Steinvil,
- S1936879815022293-9ddcfa908f510ad4c9d8af9610df8e8cNelson Bernardo,
- S1936879815022293-bf29c8f13fbb53b703a3aa00bd1aca7cHector M. Garcia-Garcia,
- S1936879815022293-bb7d56defc47dfa50850f194a4d010d0Toby Rogers,
- S1936879815022293-22ca6bb575feb9b0401e73b8ef13bd3aSarkis Kiramijyan,
- S1936879815022293-e1d8ab303901814b3704944324375e3fEddie Koifman,
- S1936879815022293-05002cb46075934f124e1def1fbd79a4Smita Negi,
- S1936879815022293-a6c1bc52851ff7a2f92d51d27345d37fSang Yeub Lee,
- S1936879815022293-3a0d6b08f0725219bdf768375029e047Michael Lipinski,
- S1936879815022293-5537c24c174de8b528bbeea792cddba0Michael A. Gaglia,
- S1936879815022293-43188b297454714a1e633ce32956ff39Rebecca Torguson,
- S1936879815022293-1afcf597a9ea0e6a884d08efd238ef1fLowell F. Satler,
- S1936879815022293-280150bfca3f0be2b424079de79e87c6Itsik Ben-Dor and
- S1936879815022293-772b1cb1fca98a9f26e1e7f8bddc725bRon Waksman
Access site related vascular complications (VC) following sheath removal related to pre-closure device failure during transcatheter aortic valve replacement (TAVR) are common and treatment options may vary.
We describe our experience with the use of a self-expandable nitinol stent graft (GORE® VIABAHN® Endoprosthesis; Gore Medical; USA) in a series of consecutive patients who underwent TAVR between the years 2013-2015, for whom failure of the pre-closer device was the indication for common femoral artery stenting.
Included were 22 TAVR patients at a mean (±SD) age of 82±8. Most of the patients were males (14, 63%), Caucasian (19, 86%), had a previous history of coronary artery disease (13, 59%) and heart failure (21, 95%). The access site was the right common femoral artery in the majority of cases (19, 86%). Most vessels had only mild calcifications and tourtuisty. The minimal luminal diameter was 7.6±1.3 mm. Overall 24 covered stents were deployed using a cross over technique from the contralateral femoral artery. The stent diameters ranged between 8-11 mm and their length was mostly 50 mm (21,87%). All deployments were successful regaining normal flow, and non of the patients required surgery. The mean HB drop was 2.8 ± 1.1 and 14 patients needed blood transfusions during hospitalization. Acute kidney injury occurred in 5 patients. Length of hospital stay was 9 ± 4 days. All patients survived during a 30 day follow up period.
The use of a self-expandable nitinol stent graft is a feasible and safe treatment option for access site related VC following TAVR.