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Vascular Complications in Transcatheter Aortic Valve Replacement With Plug-Based vs Suture-Based Closure Devices.
- Source :
-
The Canadian journal of cardiology [Can J Cardiol] 2023 Nov; Vol. 39 (11), pp. 1528-1534. Date of Electronic Publication: 2023 Jul 05. - Publication Year :
- 2023
-
Abstract
- Background: There are conflicting data regarding the efficacy and safety of suture vs plug-based vascular closure devices (VCDs) for large-bore catheter management in patients undergoing transcatheter aortic valve replacement (TAVR). We compared the rates of vascular complications (VCs) associated with 2 commonly used VCDs in a large cohort of patients undergoing TAVR.<br />Methods: We conducted a single-centre, all-comer, prospective registry study, enrolling patients undergoing TAVR for symptomatic severe aortic stenosis (AS) between the years 2009 and 2022. Clinical outcomes were compared between patients undergoing closure of the femoral access point using the MANTA VCD (M-VCD) (Teleflex, Wayne, PA) vs the ProGlide VCD (P-VCD) (Abbott Vascular, Abbott Park, IL). The main outcome measures were researcher adjudicated events of VARC-2 defined major and minor VCs.<br />Results: Overall, 2368 patients were enrolled in the registry; 1315 (51.0% male, 81.0 ± 7.0 years) patients were included in the current analysis. P-VCD was used in 813 patients, whereas M-VCD was used in 502 patients. In-hospital VCs were more frequent in the M-VCD vs the P-VCD group (17.3% vs 9.8%; P < 0.001). This outcome was mainly driven by elevated rates of minor VCs in the M-VCD group, whereas no significant difference was observed for major VCs (15.1% vs 8.4%; P < 0.001 and 2.2% vs 1.5%; P = 0.33, respectively).<br />Conclusions: In patients undergoing TAVR for severe AS, M-VCD was associated with higher rates of VCs. This outcome was mainly driven by minor VCs. The rate of major VCs was low in both groups.<br /> (Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Treatment Outcome
Femoral Artery surgery
Aortic Valve surgery
Hemostatic Techniques adverse effects
Transcatheter Aortic Valve Replacement adverse effects
Vascular Closure Devices adverse effects
Cardiovascular Diseases etiology
Aortic Valve Stenosis surgery
Aortic Valve Stenosis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1916-7075
- Volume :
- 39
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Canadian journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 37419247
- Full Text :
- https://doi.org/10.1016/j.cjca.2023.06.425