{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:31:54Z","timestamp":1789425114640,"version":"build-2803163510"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Peripheral vascular intervention (PVI) is occasionally required to facilitate delivery system insertion or to treat vascular complications during transfemoral transcatheter aortic valve replacement (TF\u2010TAVR). However, the impact of PVI on outcomes is not well understood. Therefore, we aimed to compare outcomes between TF\u2010TAVR with versus without PVI and between TF\u2010TAVR with PVI versus non\u2010TF\u2010TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively reviewed 2386 patients who underwent TAVR with a balloon\u2010expandable valve at a single institution from 2016 to 2020. The primary outcomes were death and major adverse cardiac\/cerebrovascular event (MACCE), defined as death, myocardial infarction, or stroke. Of 2246 TF\u2010TAVR recipients, 136 (6.1%) required PVI (89% bailout treatment). During follow\u2010up (median 23.0\u2009months), there were no significant differences between TF\u2010TAVR with and without PVI in death (15.4% versus 20.7%; adjusted HR [aHR], 0.96 [95% CI, 0.58\u20131.58]) or MACCE (16.9% versus 23.0%; aHR, 0.84 [95% CI, 0.52\u20131.36]). However, compared with non\u2010TF\u2010TAVR (n=140), TF\u2010TAVR with PVI carried significantly lower rates of death (15.4% versus 40.7%; aHR, 0.42 [95% CI, 0.24\u20130.75]) and MACCE (16.9% versus 45.0%; aHR, 0.40 [95% CI, 0.23\u20130.68]). Landmark analyses demonstrated lower outcome rates following TF\u2010TAVR with PVI than non\u2010TF\u2010TAVR both within 60\u2009days (death 0.7% versus 5.7%,\n              <jats:italic>P<\/jats:italic>\n              =0.019; MACCE 0.7% versus 9.3%;\n              <jats:italic>P<\/jats:italic>\n              =0.001) and thereafter (death 15.0% versus 38.9%,\n              <jats:italic>P<\/jats:italic>\n              =0.014; MACCE 16.5% versus 41.3%,\n              <jats:italic>P<\/jats:italic>\n              =0.013).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The need for PVI during TF\u2010TAVR is not uncommon, mainly due to the bailout treatment for vascular complications. PVI is not associated with worse outcomes in TF\u2010TAVR recipients. Even when PVI is required, TF\u2010TAVR is associated with better short\u2010 and intermediate\u2010term outcomes than non\u2010TF\u2010TAVR.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028878","type":"journal-article","created":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T02:27:45Z","timestamp":1686450465000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of Outcomes Following Transcatheter Aortic Valve Replacement Requiring Peripheral Vascular Intervention or Alternative Access"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2172-6447","authenticated-orcid":false,"given":"Toshiaki","family":"Isogai","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-6667","authenticated-orcid":false,"given":"Ankit","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0615-425X","authenticated-orcid":false,"given":"Shashank","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Spilias","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-7426","authenticated-orcid":false,"given":"Rishi","family":"Puri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Krishnaswamy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-073X","authenticated-orcid":false,"given":"Shinya","family":"Unai","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-3391","authenticated-orcid":false,"given":"Samir R.","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8234-3135","authenticated-orcid":false,"given":"Grant W.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000923"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.595"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2021.09.010"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.053"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023848"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10215046"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X17697832"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011756"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.02.018"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6607"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2009.00671.x"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn164"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/69.1.239"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.03.015"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780141510"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu197"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2023.101850"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-022-00868-w"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.11.019"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.020279"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005088"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.08.024"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.01.050"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008227"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.08.035"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.01.219"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.028878","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:45:33Z","timestamp":1715604333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.028878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,20]]},"references-count":32,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,6,20]]}},"alternative-id":["10.1161\/JAHA.122.028878"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.028878","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,20]]},"assertion":[{"value":"2022-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e028878"}}