{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:04:47Z","timestamp":1780988687119,"version":"3.54.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008678","name":"Universit\u00e4t Leipzig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008678","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Both angiography roadmap (RM) and ultrasound (US) are commonly used to obtain femoral arterial access during transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to evaluate the effect of implementation of an US-guided approach on vascular and bleeding complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Vascular complications and bleeding at the main access site were compared using 4-year data from two experienced TAVI-operators, who changed their practice from an exclusively RM- to an exclusively US-guided technique for access in transfemoral TAVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1026 patients were analyzed (RM: n\u2009=\u2009485, US: n\u2009=\u2009541) with a mean age of 80.7\u2009\u00b1\u20096.3\u00a0years; 47.7% were female and 37.1% received a balloon-expandable valve. Main access vascular complications, bleedings, or their composite were lower in the US-group (RM vs. US: 16.1% vs. 8.3%, p\u2009&lt;\u20090.001). US was a protective factor for vascular complications, bleeding and their composite (adjusted odds ratio [OR] 0.51, 95%-confidence interval [CI] 0.33\u20130.77, p\u2009=\u20090.002; adjusted OR 0.46, 95%-CI 0.28\u20130.78, p\u2009=\u20090.003; and adjusted OR: 0.47; 95% CI 0.32\u20130.70, p\u2009&lt;\u20090.001, respectively). Fluoroscopy time (14 [interquartile range (IQR) 11 \u2013 20] min vs. 13 [IQR 10 \u2013 17] min, p\u2009&lt;\u20090.001), contrast use (88 [IQR 69 \u2013 111]\u202fml vs. 84 [IQR 65 \u2013 110] ml, p\u2009=\u20090.049) and procedure time (52 [IQR 44 \u2013 67] min vs. 49 [IQR 41 \u2013 62] min, p\u2009=\u20090.02) were lower in the US-group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>US-guided femoral access was associated with significantly fewer complications compared with RM-guidance, supporting its adoption even among operators experienced with angiographic guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                    <jats:p>Central illustration<\/jats:p>\n                    <jats:p>(Top) Visual representation of the design of the study with examples of the used techniques: (Top left) RM and (Top right) US. (Bottom) Rates of the combined primary endpoint of vascular complications and bleedings at the main access site (middle), main access vascular complications (left) and procedural characteristics (right).<\/jats:p>\n                    <jats:p>RM\u2009=\u2009Angiographic Roadmap; US\u2009=\u2009Ultrasound, VARC-3\u2009=\u2009Valve Academic Research Consortium 3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-025-02805-2","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:01:43Z","timestamp":1765803703000},"page":"1230-1240","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound versus angiographic guided access in transfemoral TAVI: intra-operator evaluation of vascular and bleeding complications"],"prefix":"10.1007","volume":"115","author":[{"given":"Niklas","family":"Lankisch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmarco","family":"Iannopollo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Dumpies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelhafez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Rotta detto Loria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Richter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Josef","family":"Feistritzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Desch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Noack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Majunke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-558X","authenticated-orcid":false,"given":"Mohamed","family":"Abdel-Wahab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"issue":"8","key":"2805_CR1","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/J.JCIN.2011.03.019","volume":"4","author":"K Hayashida","year":"2011","unstructured":"Hayashida K, Lefvre T, Chevalier B et al (2011) Transfemoral Aortic Valve Implantation: New Criteria to Predict Vascular Complications. 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All other authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}