{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:08Z","timestamp":1753890608851,"version":"3.41.2"},"reference-count":7,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"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":"Background<\/jats:title>Severe aortic valve stenosis (AS) has become one of the leading causes of mortality in elderly patients. Currently, transcatheter aortic valve replacement (TAVR) has emerged as a crucial treatment strategy for patients with severe AS. However, numerous patients face difficulties receiving TAVR procedure due to individual patient characteristics and peripheral vascular conditions.<\/jats:p><\/jats:sec>Case report<\/jats:title>We present a case report of an elderly patient with low body weight and low-risk severe AS. In this patient, the peripheral blood vessels, particularly both iliac arteries, exhibited a notably small diameter throughout. Additionally, the aortic valve area was reduced, with valve leaflets severely calcified, significantly compromising their mobility. The patient opted for TAVR procedure. However, the traditional femoral-iliac approach for TAVR was constrained by the patient's peripheral vasculature and low BMI. Consequently, we established an artificial vascular-common iliac artery pathway as the primary access route for completing the procedure. Intraoperatively, the retrograde guidewire failed to traverse the patient's valve. As a result, an antegrade approach was adopted in combination with an in vitro<\/jats:italic> guidewire capture technique, and ultimately, the TAVR operation was completed.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our case demonstrates an innovative interventional treatment strategy for TAVR in patients with severe AS, peripheral vascular limitations, and a low BMI, for whom retrograde wire passage through the valve is not feasible.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1546342","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T05:25:54Z","timestamp":1747891554000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Alternative strategy for TAVR in the context of limited peripheral vascular access: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Liang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Jing","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xian","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1016\/j.jacc.2020.11.018","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines","volume":"77","author":"Otto","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/ccd.30918","article-title":"Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: a systematic review","volume":"103","author":"Androshchuk","year":"2024","journal-title":"Catheter Cardiovasc Interv"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1001\/jama.2021.2133","article-title":"Transcatheter treatment of valvular heart disease: a review","volume":"325","author":"Davidson","year":"2021","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","first-page":"E63","DOI":"10.1532\/HSF98.20081112","article-title":"Transcatheter aortic valve implantation through the ascending aorta: an alternative option for no-access patients","volume":"12","author":"Bauernschmitt","year":"2009","journal-title":"Heart Surg Forum"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1546342\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T05:25:55Z","timestamp":1747891555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1546342\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":7,"alternative-id":["10.3389\/fcvm.2025.1546342"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1546342","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2025,5,22]]},"article-number":"1546342"}}