{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:52:17Z","timestamp":1776678737373,"version":"3.51.2"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Plug-based vascular closure devices (Pb-VCDs) are routinely used in 14 and 18 French (F) size for percutaneous vascular access site closure during transfemoral transcatheter aortic valve replacement (TAVR). Recently, larger 18F Pb-VCDs were linked to increased incidence of vascular complications in randomized comparisons. Smaller 14F devices are hypothesized to decrease the incidence of vascular complications, but real-world data on their safety in routine clinical practice is scarce. Methods: We performed a retrospective, propensity score-matched comparison of patients receiving either 14F or 18F Pb-VCDs during TAVR from March 2019 to December 2020. The choice of 14F or 18F Pb-VCD utilization depended on the sheath size during the procedure. No other vascular closure systems (VCDs) were used despite the MANTA (Teleflex Inc.\u00ae, Morrisville, NC, USA) Pb-VCD. The primary endpoints were major and minor vascular complications defined by valve academic research consortium-3 (VARC 3) criteria. Secondary endpoints included VARC-3 bleeding events, length of hospital stay and in-hospital mortality. Results: A total of 183 (14F Pb-VCD) and 110 (18F Pb-VCD) patients were included in 1:1 propensity score matching and resulted in 85 matched patient pairs. The primary endpoint of major and minor vascular complications was balanced between the groups (major: 3.5% (14F Pb-VCD) versus (vs.) 0.0% (18F Pb-VCD), p = 0.25; minor: 12.9% vs. 14.1, p = 1.00). Secondary endpoints of VARC-3 bleeding events (p = 1.00), length of hospital stay (p = 0.34), and in-hospital mortality (p = 1.00) were equally distributed. Conclusions: There is no difference in major and minor VARC-3-defined vascular complications between the 14F and 18F groups in our study. Following this real-world observational analysis, observed rates of vascular complications need to be validated in prospective controlled trials.<\/jats:p>","DOI":"10.3390\/jcm15083095","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"3095","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vascular Complications in Transcatheter Aortic Valve Replacement Using 14 vs. 18 French Plug-Based Percutaneous Closure Devices: A Propensity Score-Matched Observational Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-4087","authenticated-orcid":false,"given":"Tobias","family":"Lerchner","sequence":"first","affiliation":[{"name":"Doctoral Programs, Witten-Herdecke University, 58455 Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norvydas","family":"Zapustas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9473-8262","authenticated-orcid":false,"given":"Melchior","family":"Seyfarth","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Tiroch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Bodensee, Witten-Herdecke University, 78464 Konstanz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-4419","authenticated-orcid":false,"given":"David","family":"Holzhey","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc Michael","family":"Vorpahl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Helios Heart Center, Witten-Herdecke University, 53721 Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","article-title":"Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey","volume":"140","author":"Iung","year":"2019","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/S0195-668X(03)00201-X","article-title":"A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease","volume":"24","author":"Iung","year":"2003","journal-title":"Eur. 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