Obesity and vascular complication in percutaneous transfemoral transcatheter aortic valve insertion
Obesity has been associated with an increased risk of vascular complication during percutaneous coronary intervention, but there are no data on the risk of vascular complication during percutaneous transfemoral transcatheter aortic valve insertion (TAVI). We hypothesized there would be a similar inc...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2023-06, Vol.101 (7), p.1221-1228 |
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| creator | Hosseini, Motahar Lahr, Brian D Greason, Kevin L Arghami, Arman Gulati, Rajiv Eleid, Mackram F Crestanello, Juan A |
| description | Obesity has been associated with an increased risk of vascular complication during percutaneous coronary intervention, but there are no data on the risk of vascular complication during percutaneous transfemoral transcatheter aortic valve insertion (TAVI).
We hypothesized there would be a similar increased risk associated with TAVI.
We reviewed the records of 1176 patients who received percutaneous transfemoral transcatheter aortic valve insertion from September 2015 to September 2020. All patients received 1) preoperative computed tomoraphy angiography assessment of the abdomen and pelvis to delineate iliofemoral artery anatomy, 2) ultrasound-guided percutaneous femoral arterial access, and 3) pre-closure of the delivery sheath femoral access site. Vascular complication was recorded based on definitions set forth by Valve Academic Research Consortium 3.
The median age of patients was 81 years, and 60% were men. The median body mass index (BMI) was 29 kg/m
(range, 11-67), and 91 (8%) patients had a value ≥40 kg/m
(i.e., morbid obesity). Delivery sheath size was 14-French in 859 (73%) patients, 16-French in 311 (26%), and 18-French in 6 (1%). Vascular complication occurred in 53 (5%) patients, including 39 (7%) among the first half of procedures and 14 (2%) among the second half (p |
| doi_str_mv | 10.1002/ccd.30658 |
| format | Article |
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We hypothesized there would be a similar increased risk associated with TAVI.
We reviewed the records of 1176 patients who received percutaneous transfemoral transcatheter aortic valve insertion from September 2015 to September 2020. All patients received 1) preoperative computed tomoraphy angiography assessment of the abdomen and pelvis to delineate iliofemoral artery anatomy, 2) ultrasound-guided percutaneous femoral arterial access, and 3) pre-closure of the delivery sheath femoral access site. Vascular complication was recorded based on definitions set forth by Valve Academic Research Consortium 3.
The median age of patients was 81 years, and 60% were men. The median body mass index (BMI) was 29 kg/m
(range, 11-67), and 91 (8%) patients had a value ≥40 kg/m
(i.e., morbid obesity). Delivery sheath size was 14-French in 859 (73%) patients, 16-French in 311 (26%), and 18-French in 6 (1%). Vascular complication occurred in 53 (5%) patients, including 39 (7%) among the first half of procedures and 14 (2%) among the second half (p < 0.001). When stratified by obesity status (BMI < or ≥30 kg/m
, p < 0.001), the complication rate was 4% in nonobese patients and 5% in obese patients. Multivariable analysis showed no overall association between risk of vascular complication and BMI categories (p = 0.583)BMI continuous values (p = 0.529), or sheath size (p = 0.217).
Obesity is not associated with a vascular complication during percutaneous transfemoral transcatheter aortic valve insertion. The operation should not be denied in obese patients.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.30658</identifier><identifier>PMID: 37036273</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged, 80 and over ; Angiography ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - etiology ; Aortic Valve Stenosis - surgery ; Body mass index ; Female ; Femoral Artery - diagnostic imaging ; Femoral Artery - surgery ; Femur ; Humans ; Male ; Obesity ; Obesity - complications ; Obesity - epidemiology ; Pelvis ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - methods ; Treatment Outcome</subject><ispartof>Catheterization and cardiovascular interventions, 2023-06, Vol.101 (7), p.1221-1228</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-22f1457ebcb2c95b34a3275f842d69d9abb10680184ae7b2ea439b32d6836f043</citedby><cites>FETCH-LOGICAL-c313t-22f1457ebcb2c95b34a3275f842d69d9abb10680184ae7b2ea439b32d6836f043</cites><orcidid>0000-0001-9729-3134 ; 0000-0001-6082-5379</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37036273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hosseini, Motahar</creatorcontrib><creatorcontrib>Lahr, Brian D</creatorcontrib><creatorcontrib>Greason, Kevin L</creatorcontrib><creatorcontrib>Arghami, Arman</creatorcontrib><creatorcontrib>Gulati, Rajiv</creatorcontrib><creatorcontrib>Eleid, Mackram F</creatorcontrib><creatorcontrib>Crestanello, Juan A</creatorcontrib><title>Obesity and vascular complication in percutaneous transfemoral transcatheter aortic valve insertion</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Obesity has been associated with an increased risk of vascular complication during percutaneous coronary intervention, but there are no data on the risk of vascular complication during percutaneous transfemoral transcatheter aortic valve insertion (TAVI).
We hypothesized there would be a similar increased risk associated with TAVI.
We reviewed the records of 1176 patients who received percutaneous transfemoral transcatheter aortic valve insertion from September 2015 to September 2020. All patients received 1) preoperative computed tomoraphy angiography assessment of the abdomen and pelvis to delineate iliofemoral artery anatomy, 2) ultrasound-guided percutaneous femoral arterial access, and 3) pre-closure of the delivery sheath femoral access site. Vascular complication was recorded based on definitions set forth by Valve Academic Research Consortium 3.
The median age of patients was 81 years, and 60% were men. The median body mass index (BMI) was 29 kg/m
(range, 11-67), and 91 (8%) patients had a value ≥40 kg/m
(i.e., morbid obesity). Delivery sheath size was 14-French in 859 (73%) patients, 16-French in 311 (26%), and 18-French in 6 (1%). Vascular complication occurred in 53 (5%) patients, including 39 (7%) among the first half of procedures and 14 (2%) among the second half (p < 0.001). When stratified by obesity status (BMI < or ≥30 kg/m
, p < 0.001), the complication rate was 4% in nonobese patients and 5% in obese patients. Multivariable analysis showed no overall association between risk of vascular complication and BMI categories (p = 0.583)BMI continuous values (p = 0.529), or sheath size (p = 0.217).
Obesity is not associated with a vascular complication during percutaneous transfemoral transcatheter aortic valve insertion. The operation should not be denied in obese patients.</description><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - etiology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Body mass index</subject><subject>Female</subject><subject>Femoral Artery - diagnostic imaging</subject><subject>Femoral Artery - surgery</subject><subject>Femur</subject><subject>Humans</subject><subject>Male</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Pelvis</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - methods</subject><subject>Treatment Outcome</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1LxDAQhoMorq4e_ANS8KKHrskkTZqjLH7Bwl4UvIUkTbFLv0zahf33Zu3qwdPMMM88DC9CVwQvCMZwb22xoJhn-RE6IxlAKoB_HB96IhmfofMQNhhjyUGeohkVmHIQ9AzZtXGhGnaJbotkq4Mda-0T2zV9XVk9VF2bVG3SO2_HQbeuG0MyeN2G0jWd1_U0RPDTDc4nuvNDZaOn3rp4F5zfGy7QSanr4C4PdY7enx7fli_pav38unxYpZYSOqQAJWGZcMYasDIzlGkKIitzBgWXhdTGEMxzTHKmnTDgNKPS0LjMKS8xo3N0O3l7332NLgyqqYJ1dT09rkBISQSlQkT05h-66Ubfxu8U5MAAKMt4pO4myvouBO9K1fuq0X6nCFb75FVMXv0kH9nrg3E0jSv-yN-o6Td2AX91</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Hosseini, Motahar</creator><creator>Lahr, Brian D</creator><creator>Greason, Kevin L</creator><creator>Arghami, Arman</creator><creator>Gulati, Rajiv</creator><creator>Eleid, Mackram F</creator><creator>Crestanello, Juan A</creator><general>Wiley Subscription Services, Inc</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>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9729-3134</orcidid><orcidid>https://orcid.org/0000-0001-6082-5379</orcidid></search><sort><creationdate>202306</creationdate><title>Obesity and vascular complication in percutaneous transfemoral transcatheter aortic valve insertion</title><author>Hosseini, Motahar ; Lahr, Brian D ; Greason, Kevin L ; Arghami, Arman ; Gulati, Rajiv ; Eleid, Mackram F ; Crestanello, Juan A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-22f1457ebcb2c95b34a3275f842d69d9abb10680184ae7b2ea439b32d6836f043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - etiology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Body mass index</topic><topic>Female</topic><topic>Femoral Artery - diagnostic imaging</topic><topic>Femoral Artery - surgery</topic><topic>Femur</topic><topic>Humans</topic><topic>Male</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Pelvis</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hosseini, Motahar</creatorcontrib><creatorcontrib>Lahr, Brian D</creatorcontrib><creatorcontrib>Greason, Kevin L</creatorcontrib><creatorcontrib>Arghami, Arman</creatorcontrib><creatorcontrib>Gulati, Rajiv</creatorcontrib><creatorcontrib>Eleid, Mackram F</creatorcontrib><creatorcontrib>Crestanello, Juan A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hosseini, Motahar</au><au>Lahr, Brian D</au><au>Greason, Kevin L</au><au>Arghami, Arman</au><au>Gulati, Rajiv</au><au>Eleid, Mackram F</au><au>Crestanello, Juan A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity and vascular complication in percutaneous transfemoral transcatheter aortic valve insertion</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2023-06</date><risdate>2023</risdate><volume>101</volume><issue>7</issue><spage>1221</spage><epage>1228</epage><pages>1221-1228</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Obesity has been associated with an increased risk of vascular complication during percutaneous coronary intervention, but there are no data on the risk of vascular complication during percutaneous transfemoral transcatheter aortic valve insertion (TAVI).
We hypothesized there would be a similar increased risk associated with TAVI.
We reviewed the records of 1176 patients who received percutaneous transfemoral transcatheter aortic valve insertion from September 2015 to September 2020. All patients received 1) preoperative computed tomoraphy angiography assessment of the abdomen and pelvis to delineate iliofemoral artery anatomy, 2) ultrasound-guided percutaneous femoral arterial access, and 3) pre-closure of the delivery sheath femoral access site. Vascular complication was recorded based on definitions set forth by Valve Academic Research Consortium 3.
The median age of patients was 81 years, and 60% were men. The median body mass index (BMI) was 29 kg/m
(range, 11-67), and 91 (8%) patients had a value ≥40 kg/m
(i.e., morbid obesity). Delivery sheath size was 14-French in 859 (73%) patients, 16-French in 311 (26%), and 18-French in 6 (1%). Vascular complication occurred in 53 (5%) patients, including 39 (7%) among the first half of procedures and 14 (2%) among the second half (p < 0.001). When stratified by obesity status (BMI < or ≥30 kg/m
, p < 0.001), the complication rate was 4% in nonobese patients and 5% in obese patients. Multivariable analysis showed no overall association between risk of vascular complication and BMI categories (p = 0.583)BMI continuous values (p = 0.529), or sheath size (p = 0.217).
Obesity is not associated with a vascular complication during percutaneous transfemoral transcatheter aortic valve insertion. The operation should not be denied in obese patients.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37036273</pmid><doi>10.1002/ccd.30658</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9729-3134</orcidid><orcidid>https://orcid.org/0000-0001-6082-5379</orcidid></addata></record> |
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| ispartof | Catheterization and cardiovascular interventions, 2023-06, Vol.101 (7), p.1221-1228 |
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| source | MEDLINE; Wiley Online Library Journals |
| subjects | Aged, 80 and over Angiography Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - etiology Aortic Valve Stenosis - surgery Body mass index Female Femoral Artery - diagnostic imaging Femoral Artery - surgery Femur Humans Male Obesity Obesity - complications Obesity - epidemiology Pelvis Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - methods Treatment Outcome |
| title | Obesity and vascular complication in percutaneous transfemoral transcatheter aortic valve insertion |
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