{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:39:08Z","timestamp":1754145548027,"version":"3.41.2"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vascular and bleeding complications remain a concern after transfemoral transcatheter aortic valve replacement (TAVR). The impact of the sheath type on these complications remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The prospective MARVEL registry study analyzed enrolled 500 patients undergoing large\u2010bore transfemoral procedures and arteriotomy closure with the MANTA vascular closure device from 10 hospitals in Europe and Canada. We stratified these patients according to type of sheath used (expandable or conventional). A propensity\u2010matched analysis was performed using VARC\u20102 major or minor vascular and bleeding complications as the primary endpoint. The secondary endpoint was time to hemostasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 196 propensity\u2010matched pairs. Major vascular complications occurred in 3.6% in the expandable sheath group and 4.1% in the conventional sheath group (<jats:italic>p<\/jats:italic>\u2009=\u20091.0). Minor vascular complications occurred in 5.6% in the expandable sheath group and 4.6% in the conventional sheath group (<jats:italic>p<\/jats:italic>\u2009=\u20090.819). There were no significant differences in bleeding complications between groups. Time to hemostasis after MANTA closure was significantly shorter in the expandable sheath group (30 vs. 60\u2009s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A propensity\u2010matched analysis demonstrated no significant differences in vascular complication rates with MANTA arteriotomy closure after removal of large bore expandable or conventional sheaths. Time to hemostasis was significantly shorter in the expandable sheath group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31396","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T03:06:06Z","timestamp":1735873566000},"page":"787-794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Sheath Type on Vascular and Bleeding Complications After Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the MARVEL Registry Study"],"prefix":"10.1002","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-6539","authenticated-orcid":false,"given":"Emily","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Surgery Central Finland Hospital Nova Jyv\u00e4skyl\u00e4 Finland"},{"name":"Department of Cardiology Turku University Hospital Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert G.","family":"Kroon","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pim A. L.","family":"Tonino","sequence":"additional","affiliation":[{"name":"Department of Cardiology Catharina Hospital Eindhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onze Lieve Vrouwe Hospital Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Laine","sequence":"additional","affiliation":[{"name":"Department of Cardiology Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evald H.","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Toggweiler","sequence":"additional","affiliation":[{"name":"Department of Cardiology Luzern Kantonsspital Luzern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5192-886X","authenticated-orcid":false,"given":"Jur","family":"Ten Berg","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Antonius Hospital Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Malmberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Turku University Hospital Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ton","family":"Slagboom","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onze Lieve Vrouwe Hospital Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8570-5901","authenticated-orcid":false,"given":"Noriaki","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology Helsinki University Hospital Helsinki Finland"},{"name":"Clinical and Medical Affairs Teleflex Inc."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian J.","family":"Terkelsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-5676","authenticated-orcid":false,"given":"Federico","family":"Moccetti","sequence":"additional","affiliation":[{"name":"Department of Cardiology Luzern Kantonsspital Luzern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Gheorghe","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Antonius Hospital Utrecht The Netherlands"},{"name":"Department of Cardiology Shonan Kamakura General Hospital Kamakura Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darra","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Clinical and Medical Affairs Teleflex Inc."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Webb","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Paul's Hospital Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Paul's Hospital Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-1205","authenticated-orcid":false,"given":"Nicholas","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Savontaus","sequence":"additional","affiliation":[{"name":"Department of Cardiology Turku University Hospital Turku 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