Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era
Abstract OBJECTIVES The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR. METHODS This retrospective study enrolled 500 consecutive p...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2021-10, Vol.60 (4), p.874-879 |
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| creator | Marie, Basile David, Charles Henri Guimbretière, Guillaume Foucher, Yohann Buschiazzo, Antoine Letocart, Vincent Manigold, Thibaut Plessis, Julien Jaafar, Philippe Morin, Hélène Rozec, Bertrand Roussel, Jean Christian Sénage, Thomas |
| description | Abstract
OBJECTIVES
The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR.
METHODS
This retrospective study enrolled 500 consecutive patients treated by TC-TAVR (n = 100) or TF-TAVR (n = 400) with percutaneous closure between January 2018 and January 2020 at the Nantes University Hospital. The primary end-point was the occurrence of cardiovascular death and cerebrovascular events at 30 days.
RESULTS
The mean age was 79.9 ± 8.1 in the TC group and 81.3 ± 6.9 (P = 0.069) in the TF group. The TC group had more men (69% vs 50.5%; P = 0.001) and more patients with peripheral vascular disease (86% vs 14.8%; P |
| doi_str_mv | 10.1093/ejcts/ezab109 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03292102v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ejcts/ezab109</oup_id><sourcerecordid>2501851329</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-ccca53a7fb49bdd3f6ff27849d6cb8f8a4a69004e8cbcb238549741ffc807e423</originalsourceid><addsrcrecordid>eNqFkb1vFDEQxS1EREKgpEUuoVjirzvbdNEJCNJJaRKJzpr1jpWNvOfF9p5E_np83BFKqpl5-r03xSPkHWefOLPyCh99LVf4BH07X5ALbrTstFQ_XradcdZpq9g5eV3KI2NsLYV-Rc6l1EJJwy5I2kBOdRzoHnNZCg04pQyRgvdY2pkyrRl2xUN9wIqZQsp19HQPcY804xzB44S7-pn6NM2QoY8HvSyxFjruaLNRv-TcEIoZ3pCzALHg29O8JPdfv9xtbrrt7bfvm-tt56W1tfPew0qCDr2y_TDIsA5BaKPssPa9CQYUrC1jCo3vfS-kWSmrFQ_BG6ZRCXlJPh5zHyC6OY8T5F8uwehurrfuoDEprOBM7HljPxzZOaefC5bqprF4jBF2mJbixIpxs-LN0NDuiPqcSskYnrM5c4c-3J8-3KmPxr8_RS_9hMMz_beAf7_TMv8n6zcGwpgr</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2501851329</pqid></control><display><type>article</type><title>Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Marie, Basile ; David, Charles Henri ; Guimbretière, Guillaume ; Foucher, Yohann ; Buschiazzo, Antoine ; Letocart, Vincent ; Manigold, Thibaut ; Plessis, Julien ; Jaafar, Philippe ; Morin, Hélène ; Rozec, Bertrand ; Roussel, Jean Christian ; Sénage, Thomas</creator><creatorcontrib>Marie, Basile ; David, Charles Henri ; Guimbretière, Guillaume ; Foucher, Yohann ; Buschiazzo, Antoine ; Letocart, Vincent ; Manigold, Thibaut ; Plessis, Julien ; Jaafar, Philippe ; Morin, Hélène ; Rozec, Bertrand ; Roussel, Jean Christian ; Sénage, Thomas</creatorcontrib><description>Abstract
OBJECTIVES
The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR.
METHODS
This retrospective study enrolled 500 consecutive patients treated by TC-TAVR (n = 100) or TF-TAVR (n = 400) with percutaneous closure between January 2018 and January 2020 at the Nantes University Hospital. The primary end-point was the occurrence of cardiovascular death and cerebrovascular events at 30 days.
RESULTS
The mean age was 79.9 ± 8.1 in the TC group and 81.3 ± 6.9 (P = 0.069) in the TF group. The TC group had more men (69% vs 50.5%; P = 0.001) and more patients with peripheral vascular disease (86% vs 14.8%; P < 0.0001). Cardiac characteristics were similar between the groups, and the EuroSCORE II was 3.8 ± 2.6% vs 4.6 ± 6.0%, respectively (P = 0.443). The 30-day mortality was 2% in the TC group versus 1% in the TF group (P = 0.345). TC-TAVR was not associated with an increased risk of stroke (2% vs 2.5%; P = 0.999) or major vascular complications (2% vs 4%; P = 0.548). More permanent pacemakers were implanted in the TF group (14.9% vs 5.6%; P = 0.015), and no moderate or severe aortic regurgitation was observed in the TC group (0 vs 3.3%; P = 0.08). TC-TAVR was not associated with an increased risk of mortality or stroke at 30 days (odds ratio 1.32; 95% confidence interval 0.42–4.21; P = 0.63) in the multivariable analysis.
CONCLUSIONS
No statistically significant differences between TC-TAVR and TF-TAVR were observed; therefore, TC-TAVR should be the first alternative in patients with anatomical contraindications to the femoral route.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezab109</identifier><identifier>PMID: 33724380</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve - surgery ; Aortic Valve Stenosis - surgery ; Femoral Artery - surgery ; Human health and pathology ; Humans ; Life Sciences ; Male ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Transcatheter Aortic Valve Replacement - adverse effects ; Treatment Outcome</subject><ispartof>European journal of cardio-thoracic surgery, 2021-10, Vol.60 (4), p.874-879</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-ccca53a7fb49bdd3f6ff27849d6cb8f8a4a69004e8cbcb238549741ffc807e423</citedby><cites>FETCH-LOGICAL-c399t-ccca53a7fb49bdd3f6ff27849d6cb8f8a4a69004e8cbcb238549741ffc807e423</cites><orcidid>0000-0003-0330-7457 ; 0000-0001-8203-0454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33724380$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03292102$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Marie, Basile</creatorcontrib><creatorcontrib>David, Charles Henri</creatorcontrib><creatorcontrib>Guimbretière, Guillaume</creatorcontrib><creatorcontrib>Foucher, Yohann</creatorcontrib><creatorcontrib>Buschiazzo, Antoine</creatorcontrib><creatorcontrib>Letocart, Vincent</creatorcontrib><creatorcontrib>Manigold, Thibaut</creatorcontrib><creatorcontrib>Plessis, Julien</creatorcontrib><creatorcontrib>Jaafar, Philippe</creatorcontrib><creatorcontrib>Morin, Hélène</creatorcontrib><creatorcontrib>Rozec, Bertrand</creatorcontrib><creatorcontrib>Roussel, Jean Christian</creatorcontrib><creatorcontrib>Sénage, Thomas</creatorcontrib><title>Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract
OBJECTIVES
The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR.
METHODS
This retrospective study enrolled 500 consecutive patients treated by TC-TAVR (n = 100) or TF-TAVR (n = 400) with percutaneous closure between January 2018 and January 2020 at the Nantes University Hospital. The primary end-point was the occurrence of cardiovascular death and cerebrovascular events at 30 days.
RESULTS
The mean age was 79.9 ± 8.1 in the TC group and 81.3 ± 6.9 (P = 0.069) in the TF group. The TC group had more men (69% vs 50.5%; P = 0.001) and more patients with peripheral vascular disease (86% vs 14.8%; P < 0.0001). Cardiac characteristics were similar between the groups, and the EuroSCORE II was 3.8 ± 2.6% vs 4.6 ± 6.0%, respectively (P = 0.443). The 30-day mortality was 2% in the TC group versus 1% in the TF group (P = 0.345). TC-TAVR was not associated with an increased risk of stroke (2% vs 2.5%; P = 0.999) or major vascular complications (2% vs 4%; P = 0.548). More permanent pacemakers were implanted in the TF group (14.9% vs 5.6%; P = 0.015), and no moderate or severe aortic regurgitation was observed in the TC group (0 vs 3.3%; P = 0.08). TC-TAVR was not associated with an increased risk of mortality or stroke at 30 days (odds ratio 1.32; 95% confidence interval 0.42–4.21; P = 0.63) in the multivariable analysis.
CONCLUSIONS
No statistically significant differences between TC-TAVR and TF-TAVR were observed; therefore, TC-TAVR should be the first alternative in patients with anatomical contraindications to the femoral route.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Femoral Artery - surgery</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Treatment Outcome</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkb1vFDEQxS1EREKgpEUuoVjirzvbdNEJCNJJaRKJzpr1jpWNvOfF9p5E_np83BFKqpl5-r03xSPkHWefOLPyCh99LVf4BH07X5ALbrTstFQ_XradcdZpq9g5eV3KI2NsLYV-Rc6l1EJJwy5I2kBOdRzoHnNZCg04pQyRgvdY2pkyrRl2xUN9wIqZQsp19HQPcY804xzB44S7-pn6NM2QoY8HvSyxFjruaLNRv-TcEIoZ3pCzALHg29O8JPdfv9xtbrrt7bfvm-tt56W1tfPew0qCDr2y_TDIsA5BaKPssPa9CQYUrC1jCo3vfS-kWSmrFQ_BG6ZRCXlJPh5zHyC6OY8T5F8uwehurrfuoDEprOBM7HljPxzZOaefC5bqprF4jBF2mJbixIpxs-LN0NDuiPqcSskYnrM5c4c-3J8-3KmPxr8_RS_9hMMz_beAf7_TMv8n6zcGwpgr</recordid><startdate>20211022</startdate><enddate>20211022</enddate><creator>Marie, Basile</creator><creator>David, Charles Henri</creator><creator>Guimbretière, Guillaume</creator><creator>Foucher, Yohann</creator><creator>Buschiazzo, Antoine</creator><creator>Letocart, Vincent</creator><creator>Manigold, Thibaut</creator><creator>Plessis, Julien</creator><creator>Jaafar, Philippe</creator><creator>Morin, Hélène</creator><creator>Rozec, Bertrand</creator><creator>Roussel, Jean Christian</creator><creator>Sénage, Thomas</creator><general>Oxford University Press</general><general>Oxford University Press (OUP)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-0330-7457</orcidid><orcidid>https://orcid.org/0000-0001-8203-0454</orcidid></search><sort><creationdate>20211022</creationdate><title>Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era</title><author>Marie, Basile ; David, Charles Henri ; Guimbretière, Guillaume ; Foucher, Yohann ; Buschiazzo, Antoine ; Letocart, Vincent ; Manigold, Thibaut ; Plessis, Julien ; Jaafar, Philippe ; Morin, Hélène ; Rozec, Bertrand ; Roussel, Jean Christian ; Sénage, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-ccca53a7fb49bdd3f6ff27849d6cb8f8a4a69004e8cbcb238549741ffc807e423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Femoral Artery - surgery</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marie, Basile</creatorcontrib><creatorcontrib>David, Charles Henri</creatorcontrib><creatorcontrib>Guimbretière, Guillaume</creatorcontrib><creatorcontrib>Foucher, Yohann</creatorcontrib><creatorcontrib>Buschiazzo, Antoine</creatorcontrib><creatorcontrib>Letocart, Vincent</creatorcontrib><creatorcontrib>Manigold, Thibaut</creatorcontrib><creatorcontrib>Plessis, Julien</creatorcontrib><creatorcontrib>Jaafar, Philippe</creatorcontrib><creatorcontrib>Morin, Hélène</creatorcontrib><creatorcontrib>Rozec, Bertrand</creatorcontrib><creatorcontrib>Roussel, Jean Christian</creatorcontrib><creatorcontrib>Sénage, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marie, Basile</au><au>David, Charles Henri</au><au>Guimbretière, Guillaume</au><au>Foucher, Yohann</au><au>Buschiazzo, Antoine</au><au>Letocart, Vincent</au><au>Manigold, Thibaut</au><au>Plessis, Julien</au><au>Jaafar, Philippe</au><au>Morin, Hélène</au><au>Rozec, Bertrand</au><au>Roussel, Jean Christian</au><au>Sénage, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2021-10-22</date><risdate>2021</risdate><volume>60</volume><issue>4</issue><spage>874</spage><epage>879</epage><pages>874-879</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>Abstract
OBJECTIVES
The carotid approach for transcatheter aortic valve replacement (TAVR) has been shown to be feasible and safe. The goal of this study was to compare the 30-day outcomes of trans-carotid (TC) and transfemoral (TF) TAVR.
METHODS
This retrospective study enrolled 500 consecutive patients treated by TC-TAVR (n = 100) or TF-TAVR (n = 400) with percutaneous closure between January 2018 and January 2020 at the Nantes University Hospital. The primary end-point was the occurrence of cardiovascular death and cerebrovascular events at 30 days.
RESULTS
The mean age was 79.9 ± 8.1 in the TC group and 81.3 ± 6.9 (P = 0.069) in the TF group. The TC group had more men (69% vs 50.5%; P = 0.001) and more patients with peripheral vascular disease (86% vs 14.8%; P < 0.0001). Cardiac characteristics were similar between the groups, and the EuroSCORE II was 3.8 ± 2.6% vs 4.6 ± 6.0%, respectively (P = 0.443). The 30-day mortality was 2% in the TC group versus 1% in the TF group (P = 0.345). TC-TAVR was not associated with an increased risk of stroke (2% vs 2.5%; P = 0.999) or major vascular complications (2% vs 4%; P = 0.548). More permanent pacemakers were implanted in the TF group (14.9% vs 5.6%; P = 0.015), and no moderate or severe aortic regurgitation was observed in the TC group (0 vs 3.3%; P = 0.08). TC-TAVR was not associated with an increased risk of mortality or stroke at 30 days (odds ratio 1.32; 95% confidence interval 0.42–4.21; P = 0.63) in the multivariable analysis.
CONCLUSIONS
No statistically significant differences between TC-TAVR and TF-TAVR were observed; therefore, TC-TAVR should be the first alternative in patients with anatomical contraindications to the femoral route.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>33724380</pmid><doi>10.1093/ejcts/ezab109</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-0330-7457</orcidid><orcidid>https://orcid.org/0000-0001-8203-0454</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Aortic Valve - surgery Aortic Valve Stenosis - surgery Femoral Artery - surgery Human health and pathology Humans Life Sciences Male Retrospective Studies Risk Assessment Risk Factors Time Factors Transcatheter Aortic Valve Replacement - adverse effects Treatment Outcome |
| title | Carotid versus femoral access for transcatheter aortic valve replacement: comparable results in the current era |
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