{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:37:11Z","timestamp":1788449831869,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Trans\u2010femoral (TF) access is the commonest approach for transcatheter aortic valve implantation (TAVI). However this vascular approach is associated with vascular complications (VC) which in turn have prognostic implications. The aim of this study is to evaluate the clinical impact of access site VC in patients undergoing TAVI with newer generation transcatheter prostheses enrolled in the national observational prospective multicenter study OBSERVANT II.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vascular events were defined according to the Valve Academic Research Consortium (VARC)\u20102 criteria. The population enrolled in OBSERVANT II was divided into 3 groups: patients without VC (No\u2010VC), patients with minor VC or percutaneous closure device failure (Minor\u2010VC) and patients with major VC (Major\u2010VC). The primary endpoint was 1\u2010year major adverse cardiac and cerebrovascular event (MACCE), a composite endpoint of all\u2010cause mortality, stroke, myocardial infarction and coronary revascularization. A multivariate Cox regression model was used for risk estimation of MACCE between the three analyzed groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>2.504 patients were included in this analysis: 2.167 patients in No\u2010VC group; 249 patients in the Minor\u2010VC and 88 patients in the Major\u2010VC. At 1\u2010year Minor\u2010VC group had a freedom from MACCE comparable to the No\u2010VC group, while Major\u2010VC patients had significantly worse outcome (Log\u2010rank test: <jats:italic>p<\/jats:italic>\u2009=\u20090.003). These results were driven by higher 1\u2010year mortality in the Major\u2010VC (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Major\u2010VC was an independent predictor of MACCE in adjusted analysis (hazard ratio\u00a01.89, 95%\u00a0confidence interval 1.18\u20103.03, <jats:italic>p<\/jats:italic>\u2009=\u20090.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite a low incidence of major VC with current TF\u2010TAVI devices, our data confirm that major VC is still associated with a significantly worse clinical outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30695","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T14:17:34Z","timestamp":1685715454000},"page":"381-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of vascular complications after transcatheter aortic valve implantation. VASC\u2010OBSERVANT II sub\u2010study"],"prefix":"10.1002","volume":"102","author":[{"given":"Cristina","family":"Aurigemma","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9777-013X","authenticated-orcid":false,"given":"Carlo","family":"Trani","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Roma Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore Roma Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"D'Errigo","sequence":"additional","affiliation":[{"name":"National Centre for Global Health, Istituto Superiore di Sanit\u00e0 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Barbanti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Enna \"Kore\" Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8186","authenticated-orcid":false,"given":"Fausto","family":"Biancari","sequence":"additional","affiliation":[{"name":"Heart and Lung Center, Helsinki University Hospital University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-2917","authenticated-orcid":false,"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, Division of Cardiology University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Santoro","sequence":"additional","affiliation":[{"name":"Fondazione \u201c G. Monasterio\u201d CNR\/Regione Toscana per la Ricerca Medica e la Sanit\u00e0 Pubblica Massa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Baiocchi","sequence":"additional","affiliation":[{"name":"Policlinico Sant'Orsola Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Baglio","sequence":"additional","affiliation":[{"name":"Italian National Agency for Regional Healthcare Services Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvia","family":"Seccareccia","sequence":"additional","affiliation":[{"name":"National Centre for Global Health, Istituto Superiore di Sanit\u00e0 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Rosato","sequence":"additional","affiliation":[{"name":"National Centre for Global Health, Istituto Superiore di Sanit\u00e0 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the 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