Author + information
- Sukhdeep S. Basra,
- Deborah Tabachnick,
- John Squiers,
- Giovanni Filardo,
- Benjamin Pollock,
- Molly Szerlip,
- David Brown,
- William Brinkman,
- Katherine Harrington,
- Paul Grayburn,
- Michael Mack and
- J. Michael DiMaio, Srinivasa Potluri
Background: Whether ultrasound-guided (USG) access reduces vascular complications in patients undergoing TAVR is unknown. We compared outcomes of USG vs fluoroscopy-guided (FG) access in patients undergoing TAVR.
Methods: A retrospective review of patients at a single center undergoing TF-TAVR with the Sapien 3 valve between 10/2013-6/2016 was performed. Data on access site, vessel size, vascular complications were analyzed after adjustment by Society of Thoracic Surgeons (STS) risk score.
Results: TF-TAVR was performed in 224 patients (109 [49%] USG; 115 [51%] FG). Mean STS risk score was similar in both groups: 6.8±0.3 USG and 6.7±0.3 FG (p=0.78). A trend towards smaller diameter of the accessed common femoral artery in USG vs FG was apparent (adjusted mean difference −0.45mm, p=0.06). Vascular complications occurred in 22 (9.8%) patients: 8 (7.3%) USG and 14 (12.2%) FG (USG vs FG: STS Risk score adjusted Odds Ratio 0.59, 95%CI 0.24–1.48, p=0.26) (Table).
Conclusions: US-guided access appears to be associated with lower vascular complication rates in patients undergoing TAVR with a contemporary valve system. However, this association was not significant given the small study population. Given these preliminary findings, studies of larger cohorts are necessary to further determine the association between USG-access and vascular complications.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Access and Hemostasis Issues
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1192-128
- 2017 American College of Cardiology Foundation