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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).
- Source :
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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
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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.)
- Subjects :
- Aged
Aged, 80 and over
Aortic Dissection epidemiology
Blood Loss, Surgical statistics & numerical data
Female
Humans
Male
Multidetector Computed Tomography
Aorta diagnostic imaging
Femoral Artery diagnostic imaging
Iliac Artery diagnostic imaging
Intraoperative Complications epidemiology
Postoperative Hemorrhage epidemiology
Transcatheter Aortic Valve Replacement methods
Vascular System Injuries epidemiology
Subjects
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