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Nevertheless, there remain concerns about vascular complications, lack of compressibility, and thorax-related complications. Between March 2019 and March 2021, 13 patients underwent transaxillary TAVR for severe aortic stenosis at the University Hospital Bonn. The puncture was performed with a puncture at the distal segment of the axillary artery through the axilla, with additional femoral access for applying a safety wire inside the axillary artery. Device success was defined according to the VARC 2 criteria. The study participants were advanced in age (77\u2009\u00b1\u20099\u00a0years old), and 54% were female, with an intermediate risk for surgery (STS risk score 4.7\u2009\u00b1\u20092.0%). The average diameter of the distal segment of the axillary artery was 5.8\u2009\u00b1\u20091.0\u00a0mm (i.e., the puncture site) and 7.6\u2009\u00b1\u20090.9\u00a0mm for the proximal axillary artery. Device success was achieved in all patients. 30-day major adverse cardiac and cerebrovascular events were 0%. With complete percutaneous management, stent-graft implantation was performed at the puncture site in 38.5% of patients. Minor bleeding was successfully managed with manual compression. Moreover, no thorax-related complications, hematomas, or nerve injuries were observed. Percutaneous trans-axilla TAVR was found to be feasible and safe. This modified approach may mitigate the risk of bleeding and serious complications in the thorax and be less invasive than surgical alternatives.<\/jats:p>","DOI":"10.1007\/s00380-022-02082-3","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T16:03:40Z","timestamp":1651593820000},"page":"1801-1807","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Percutaneous trans-axilla transcatheter aortic valve replacement"],"prefix":"10.1007","volume":"37","author":[{"given":"Atsushi","family":"Sugiura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsumasa","family":"Sudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baravan","family":"Al-Kassou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Shamekhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Silaschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Wilde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Sedaghat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich Marc","family":"Becher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Malte","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhard","family":"Grube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstratios I.","family":"Charitos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Zimmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"2082_CR1","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","volume":"380","author":"JJ Popma","year":"2019","unstructured":"Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O\u2019Hair D, Bajwa T, Heiser JC, Merhi W, Kleiman NS, Askew J, Sorajja P, Rovin J, Chetcuti SJ, Adams DH, Teirstein PS, Zorn GL, Forrest JK, Tch\u00e9tch\u00e9 D, Resar J, Walton A, Piazza N, Ramlawi B, Robinson N, Petrossian G, Gleason TG, Oh JK, Boulware MJ, Qiao H, Mugglin AS, Reardon MJ, Evolut low risk trial investigators (2019) Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. 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Marcel Weber has received lecture or proctoring fees from Edwards Lifesciences. Eberhard Grube serves on an advisory board for Medtronic and Boston scientific and has received speaking honoraria and research grants from Abbott, Medtronic, Boston scientific, and Edwards Lifesciences. Georg Nickenig has received research funding from Edwards Lifesciences, Medtronic, and St Jude Medical and has received honoraria for lectures or advisory boards from Edwards Lifesciences, Medtronic, and St Jude Medical. Efstratios I. Charitos: significant stock: Edwards Lifesciences; Medtronic. The other authors have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}