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The Iliofemoral tortuosity score predicts access and bleeding complications during transfemoral transcatheter aortic valve replacement: DataData from the VIenna Cardio Thoracic aOrtic valve registrY (VICTORY).

Authors :
Mach M
Poschner T
Hasan W
Szalkiewicz P
Andreas M
Winkler B
Geisler S
Geisler D
Rudziński PN
Watzal V
Strouhal A
Adlbrecht C
Delle-Karth G
Grabenwöger M
Source :
European journal of clinical investigation [Eur J Clin Invest] 2021 Jun; Vol. 51 (6), pp. e13491. Date of Electronic Publication: 2021 Feb 02.
Publication Year :
2021

Abstract

Background: Arterial tortuosity is linked to a higher risk of adverse clinical events after transfemoral transcatheter aortic valve replacement (TF-TAVR). Currently, there are no assessment tools that can quantify this variable in three-dimensional space. This study investigated the impact of novel scoring methods of iliofemoral tortuosity on access and bleeding complications after TF-TAVR.<br />Methods: The main access vessel was assessed between the aortoiliacal and femoral bifurcation in preoperative multislice computed tomography scans of 240 consecutive patients undergoing TF-TAVR. Tortuosity was assessed by three methods: largest single angle, sum of all angles, and iliofemoral tortuosity (IFT) score [((true vessel length/ideal vessel length)-1)*100]. The primary study endpoint was a composite of access and bleeding complications. The secondary study endpoints were 30-day mortality and long-term survival.<br />Results: Among 240 patients, only the IFT score demonstrated a good positive correlation with the composite primary endpoint of access and bleeding complications (P = 0.031). A higher incidence of access and bleeding complications was found in patients with a higher IFT score (56 [36.8%] vs 17 [19.3%]; P = 0.003). In a multivariate logistic regression analysis, only the IFT score was a significant predictor of the primary endpoint (OR: 2.11; 95% CI: 1.09-4.05; P = 0.026).<br />Conclusion: Vascular tortuosity is an underestimated risk factor during TF-TAVR. The IFT score is a valuable tool in risk stratification before TF-TAVR, predicting periprocedural access and bleeding complications.<br /> (© 2021 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)

Details

Language :
English
ISSN :
1365-2362
Volume :
51
Issue :
6
Database :
MEDLINE
Journal :
European journal of clinical investigation
Publication Type :
Academic Journal
Accession number :
33432599
Full Text :
https://doi.org/10.1111/eci.13491