Comparison of Transfemoral Versus Transradial Secondary Access in Transcatheter Aortic Valve Replacement

• DOI: 10.1161/circinterventions.119.008609
• Publication Date: 2020-02-24T10:00:28Z
• Authors: Lucía Junquera; Marina Urena; Azeem Latib; Antonio Muñoz-Garcia; Luis Nombela-Franco; Benjamin Faurie; Gabriela Veiga-Fe...; Alberto Alperi; Vicenç Serra; Ander Regueiro; Quentin Fischer; Dominique Himbert; Antonio Mangieri; Antonio Colombo; Erika Muñoz-García; Rafael Vera-Urquiza; Pilar Jiménez-Que...; Jose Maria de la ...; Isaac Pascual; Bruno Garcia del ...; Manel Sabaté; Siamak Mohammadi; Afonso B. Freitas...; Leonardo Guimarães; Thomas Couture; Melanie Côté; Josep Rodés-Cabau
• Keywords: Valve replacement; Stroke

Transfemoral approach has been commonly used as secondary access in transcatheter aortic valve replacement (TAVR). Scarce data exist on the use and potential clinical benefits of transradial during TAVR procedures. The objective study is to determine occurrence vascular complications (VC) outcomes according (transfemoral versus transradial) patients undergoing TAVR.This was a multicenter including 4949 who underwent (mean age, 81±8 years, mean Society Thoracic Surgeons score, 4.9 [3.3-7.5]). approaches were 4016 (81.1%) 933 (18.9%) patients, respectively. 30-day events (vascular bleeding complications, stroke, acute kidney injury, mortality) evaluated defined Valve Academic Research Consortium-2 criteria. Clinical analyzed overall population propensity score-matched involving 2978 transfemoral 928 patients.Related-access VC occurred 834 (16.9%) (major VC, 5.7%) related 172 (3.5%) 1.3%). rate higher group (VC, 4.1% 0.9%, P<0.001; major 1.6% 0%, P<0.001). In population, remained (4.7% 1.8% P<0.001), which also exhibited major/life-threatening (1.0% Significant differences between groups observed regarding rates stroke (transfemoral: 3.1%, transradial: 1.6%; P=0.043), injury 9.9%, 5.7%; mortality 4.0%, 2.4%, P=0.047).The procedures associated with significant reduction improved outcomes. Future randomized studies are warranted.