{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:01:38Z","timestamp":1768881698241,"version":"3.49.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold>Transcatheter aortic valve implantation (TAVI) has rapidly developed over the last decade and is nowadays the treatment of choice in the elderly patients irrespective of surgical risk. The outcome of these patients is mainly determined not only by the interventional procedure itself, but also by its complications.<\/jats:p><jats:p><jats:bold>Material and Methods:<\/jats:bold>We analyzed the outcome and procedural events of transfemoral TAVI procedures performed per year at our institution. The mean age of these patients is 79.2 years and 49% are female. All the patients underwent duplex ultrasonography of the iliac arteries and inguinal vessels before the procedure and CT of the aorta and iliac arteries.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>Transfemoral access route is associated with a number of challenges and complications, especially in the patients suffering from peripheral artery disease (PAD). The rate of vascular complications at our center was 2.76% (19\/689). Typical vascular complications (VC) include bleeding and pseudoaneurysms at the puncture site, acute or subacute occlusion of the access vessel, and dissection or perforation of the iliac vessels. In addition, there is the need for primary PTA of the access pathway in the presence of additional PAD of the common femoral artery (CFA) and iliac vessels. Balloon angioplasty, implantation of covered and uncovered stents, lithoplasty, and ultrasound-guided thrombin injection are available to treat the described issues.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold>Interventional therapy of access vessels can preoperatively enable the transfemoral approach and successfully treat post-operative VC in most of the cases. Training the heart team to address these issues is a key focus, and an interventional vascular specialist should be part of this team.<\/jats:p>","DOI":"10.3389\/fcvm.2021.725079","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T05:48:26Z","timestamp":1636955306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Interventional Treatment of Access Site Complications During Transfemoral TAVI: A Single Center Experience"],"prefix":"10.3389","volume":"8","author":[{"given":"Marcus","family":"Thieme","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Moebius-Winkler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Franz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Baez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian P.","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Butter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Edlinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kretzschmar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s12181-020-00398-w","article-title":"Konsensuspapier der Deutschen Gesellschaft f\u00fcr Kardiologie (DGK) und der Deutschen Gesellschaft f\u00fcr Thorax, Herz- und Gef\u00e4\u00dfchirurgie (DGTHG) zur kathetergest\u00fctzten Aortenklappenimplantation (TAVI) 2020","volume":"14","author":"Kuck","year":"2020","journal-title":"Kardiologe."},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/2582938","article-title":"TAVR: a review of current practices and considerations in low-risk patients","volume-title":"J Interv Cardiol","author":"Spears","year":"2020"},{"key":"B3","doi-asserted-by":"publisher","first-page":"72","DOI":"10.21037\/cdt.2019.10.01","article-title":"Review of alternative access in transcatheter aortic valve replacement","volume":"10","author":"Banks","year":"2020","journal-title":"Cardiovasc Diagn Ther"},{"key":"B4","first-page":"32","article-title":"Systematic review of randomized controlled trials comparing manual compression to vascular closure devices for diagnostic and therapeutic arterial procedures","volume":"27","author":"Cox","year":"2016","journal-title":"Surg Technol Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"15266028211025044","DOI":"10.1161\/CIRCRESAHA.116.303503","article-title":"Access site complications of peripheral endovascular procedures: a large, prospective registry on predictors and consequences","volume":"17","author":"Cacuci","year":"2021","journal-title":"J Endovasc Ther."},{"key":"B6","doi-asserted-by":"crossref","DOI":"10.1016\/j.acvd.2015.03.007","article-title":"Management of vascular complications following transcatheter aortic valve implantation","volume-title":"Arch Cardiovasc Dis","author":"Perrin","year":"2015"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e008227","DOI":"10.1161\/CIRCINTERVENTIONS.119.008227","article-title":"Incidence, temporal trends, and associated outcomes of vascular and bleeding complications in patients undergoing transfemoral transcatheter aortic valve replacement: insights from the society of thoracic surgeons\/American College of Cardiology Transcathe","volume":"13","author":"Sherwood","year":"2020","journal-title":"Circ Cardiovasc Interv."},{"key":"B8","doi-asserted-by":"crossref","first-page":"E302","DOI":"10.25270\/jic\/20.00432","article-title":"Clinical impact of crossover techniques for primary access hemostasis in transfemoral transcatheter aortic valve replacement procedures","volume":"33","author":"Junquera","year":"2021","journal-title":"J Invasive Cardiol."},{"key":"B9","first-page":"318","article-title":"Ultrasound-guided catheterization of the femoral artery: a systematic review and meta-analysis of randomized controlled trials","volume":"27","author":"Sobolev","year":"2015","journal-title":"J Invasive Cardiol"},{"key":"B10","article-title":"Ultrasound Guidance in Femoral Artery Catheterization: A Systematic Review and a Meta-Analysis of Randomized Controlled Trials","volume-title":"J Invasive Cardiol.","author":"Rashid","year":"2019"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e005456","DOI":"10.1161\/CIRCINTERVENTIONS.117.005456","article-title":"Peripheral artery disease and transcatheter aortic valve replacement outcomes: a report from the society of thoracic surgeons\/American College of Cardiology Transcatheter Therapy Registry","volume":"10","author":"Fanaroff","year":"2017","journal-title":"Circ Cardiovasc Interv"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1016\/j.jcin.2019.05.017","article-title":"Factors associated with and outcomes of aborted procedures during elective transcatheter aortic valve replacement","volume":"12","author":"Rymer","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"B13","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.ahj.2012.04.016","article-title":"The impact of peripheral arterial disease on early outcome after transcatheter aortic valve implantation: results from the German Transcatheter Aortic Valve Interventions Registry","volume":"164","author":"Sinning","year":"2012","journal-title":"Am Heart J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1093\/eurheartj\/ehz733","article-title":"TAVI is on the move! How it compares with surgery and what complications we still have to consider","volume":"40","author":"L\u00fcscher","year":"2019","journal-title":"Eur Heart J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.amjcard.2019.10.036","article-title":"Meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with low surgical risk","volume":"125","author":"Vipparthy","year":"2020","journal-title":"Am J Cardiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2728","DOI":"10.1016\/j.jacc.2019.09.054","article-title":"Femoral versus nonfemoral peripheral access for transcatheter aortic valve replacement","volume":"74","author":"Beurtheret","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"537","DOI":"10.4149\/BLL_2020_089","article-title":"Combined percutaneous approach for aortic valve implantation in poor vascular access","volume":"121","author":"Kala","year":"2020","journal-title":"Bratisl Lek Listy"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1878","DOI":"10.1093\/eurheartj\/ehy213","article-title":"State of the art in TAVI: a revolution in patient care is taking place, but there is much still to learn as discussed by Dr. Miles Dalby","volume":"39","author":"Dalby","year":"2018","journal-title":"Eur Heart J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"372","DOI":"10.23736\/S0026-4806.20.06640-9","article-title":"Economic assessment of traditional surgical valve replacement versus use of transfemoral intervention in degenerative aortic stenosis","volume":"112","author":"Edlinger","year":"2021","journal-title":"Minerva Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1890","DOI":"10.3390\/jcm10091890","article-title":"Real world performance evaluation of transcatheter aortic valve implantation","volume":"10","author":"Pesarini","year":"2021","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1002\/ccd.25991","article-title":"Poor mobility predicts adverse outcome better than other frailty indices in patients undergoing transcatheter aortic valve implantation","volume":"86","author":"Cockburn","year":"2015","journal-title":"Catheter Cardiovasc Interv"},{"key":"B22","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3390\/jcm7100326","article-title":"Impact of rehabilitation on outcomes after TAVI: a preliminary study","volume":"7","author":"Butter","year":"2018","journal-title":"J Clin Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12872-020-01452-x","article-title":"Geriatric or cardiac rehabilitation? Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation","volume":"20","author":"Eichler","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"B24","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1177\/0003319717711589","article-title":"Surgical managament of percutaneous transfemoral access to minimize vascular complications related to transcatheter aortiv valve implantation","volume":"69","author":"Lareyre","year":"2018","journal-title":"Angiology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.avsg.2020.12.032","article-title":"Vascular access complications and clinical outcomes of vascular surgical repairs following transcatheter aortic valve implantation (TAVI)","volume":"74","author":"Sinclair","year":"2021","journal-title":"Ann VAsc Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"17","DOI":"10.15420\/icr.2018.36.1","article-title":"Large-bore vascular closure: new devices and techniques","volume":"14","author":"van Wiechen","year":"2019","journal-title":"Interv Cardiol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e1558","DOI":"10.4244\/EIJ-D-18-00769","article-title":"Propensity-matched comparison of vascular closure devices after transcatheter aortic valve replacement using MANTA versus ProGlide","volume":"14","author":"Moriyama","year":"2019","journal-title":"Eurointervention."},{"key":"B28","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1177\/1553350619848557","article-title":"The current status of lithoplasty in vascular calcifications: a systematic review","volume":"26","author":"Khan","year":"2019","journal-title":"Surg Innov"},{"key":"B29","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1177\/1526602820914598","article-title":"Intravascular lithotripsy for treatment of calcified lower extremity arterial stenosis: initial analysis of the disrupt PAD III study","volume":"27","author":"Adams","year":""}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.725079\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T04:01:25Z","timestamp":1726113685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.725079\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":29,"alternative-id":["10.3389\/fcvm.2021.725079"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.725079","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]},"article-number":"725079"}}