Trends in Vascular Complications in High Risk Patients Following Transcatheter Aortic Valve Replacement in the United States

Vascular complications (VC) following transcatheter aortic valve replacement (TAVR) is associated with worse outcomes. The trend of VC incidence in patients considered high-risk is unclear. We sought to assess the trend of VC after TAVR in patients at high-risk. We investigated the VC trend in female, diabetes (DM) and peripheral vascular disease (PVD). Patients who underwent TAVR from 2011 to 2014 in the United States were identified using ICD-9 code 35.05 from the Nationwide Inpatient Sample database. Frequency of any VC (per 100 TAVI procedure or hospital discharges) for each year from 2011 through 2014 was assessed for the overall population as well as within each category of high-risk cohorts. The overall VC rate was 6.0% (2,044/33,790). Patients who had VC were more likely to be female and had higher rates of PVD at baseline. The annual rate of VC in the overall population from 2011 to 2014 was 4.6%, 9.4%, 6.8% and 4.4%, respectively. There was a significant increase in VC rate from 2011 to 2012 (p=0.03) whereas there was a significant decrease in VC rate from 2012 to 2014 (p