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There is only limited evidence regarding the efficacy and safety of covered balloon-expandable (CBE) stents in the management of Tf-TAVI related vascular complications. We aimed to investigate the efficacy and safety of CBE stent implantation to treat access-related vascular complications in patients undergoing Tf-TAVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present retrospective analysis included patients undergoing CBE stent implantation following Tf-TAVI from April 2012 to January 2023 at our centre. The primary endpoint was technical success defined as successful device delivery and implantation at the intended location with angiographic confirmation of vessel patency and absence of residual bleeding. Clinical outcomes and color Doppler ultrasonography findings were evaluated at discharge, 30\u00a0days and longest available follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3331 Tf-TAVI procedures, 93 patients (2.8%) required covered stent implantation for the treatment of access related vascular complications. Technical success was achieved in 92 patients (98.9%). BeGraft and Atrium Advanta V12 CBE stents were implanted in 76 (81.7%) and 17 (18.3%) patients, respectively. Median clinical follow-up was 455 [304; 798] days, with both in-hospital and 30-days mortality equaling 4.3% and 1-year mortality 15.1%. Pre-discharge Doppler ultrasonography was performed in 98.9% patients, with normal findings in 79.8% and minor findings (such as pseudoaneurysm, non-flow-limiting dissection, arterio-venous fistula) in the remaining patients. Clinical follow-up was available in 96.2% patients; no cases of new-onset claudication, need for repeat surgical or transcatheter vascular interventions were recorded. Follow-up Doppler ultrasonography (54.4% patients) showed persistent patency and no signs of stent failure in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CBE stent implantation for the treatment of access site related vascular complications after Tf-TAVI is associated with excellent technical success rates, optimal short- to mid-term patency rates as well as satisfactory long-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-025-02651-2","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T08:38:59Z","timestamp":1747298339000},"page":"1120-1130","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mid- to long-term outcomes of covered balloon-expandable stent implantation for the management of vascular injuries in patients undergoing transfemoral transcatheter aortic valve implantation: the BE-SAFE Registry"],"prefix":"10.1007","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-9530","authenticated-orcid":false,"given":"Hector A.","family":"Alvarez-Covarrubias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Jurisic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Syryca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Duesmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costanza","family":"Pellegrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Rheude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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Alvarez-Covarrubias received lecture fees from SIS Medical AG, LifeTech and Edward Lifesciences, proctor fees from LifeTech and financial support for attending meetings or travel expenses from Abbott Vascular and LifeTech, not related to the current work. Salvatore Cassese reports consulting fees from SIS Medical, lecture fees from Abiomed, Astra Zeneca, SIS Medical and Teleflex, and financial support for attending meetings or travel expenses from SIS Medical, not related to the current work. Tobias Rheude received lecture fees from SIS Medical AG and AstraZeneca, not related to the current work. Sebastian Kufner reports speaker and consulting fees from AstraZeneca, Bristol Myers Squibb, and Bentley and speaker fees from Abbott, Boehringer-Ingelheim and Translumina and a research grant from Bentley, not related the current work. Heribert Schunkert reports personal fees from AMGEN, Daiichi-Sankyo, MSD Sharp&Dohme, Astra-Zeneca, Bazer Vital, Boehringer-Ingelheim, Novartis, Servier, Sanofi Aventis and Synlab not related to the current work. Michael Joner reports personal fees from Abbott, Alchimedics S.A.S., Astra Zeneca, Biotronik, Medtronic, Recor, Shockwave, TriCares, Veryan, grants and personal fees from Boston Scientific, Cardiac Dimensions, Edwards, grant from Infraredx outside the submitted work. Erion Xhepa reports consulting services for Edwards Lifesciences, lecture fees and honoraria from AstraZeneca, Boston Scientific, SIS Medical and Translumina not related to the current work; proctor fees from Abbott Vascular and financial support for attending meetings and\/or travel expenses from Abbott Vascular and SIS Medical. The remaining authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}