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Updated: May 18, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Transcatheter aortic valve replacement and vascular complications definitions
Nicolas M Van Mieghem1, Philippe Généreux, Robert M A van der Boon
1Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Summary
Vascular complication rates in transcatheter aortic valve replacement (TAVR) vary significantly due to differing definitions. Adopting standardized Valve Academic Research Consortium (VARC) definitions is crucial for reliable TAVR outcome comparisons.
Area of Science:
- Cardiovascular Interventions
- Medical Device Technology
- Clinical Trial Methodology
Background:
- Transcatheter aortic valve replacement (TAVR) necessitates large-bore catheters, increasing the risk of vascular complications.
- Variability in defining major vascular complications (MVCs) hinders accurate comparison of TAVR outcomes across studies.
Purpose of the Study:
- To assess the impact of diverse definitions of MVCs on their reported incidence in TAVR.
- To emphasize the necessity of uniform reporting standards for vascular complications in TAVR procedures.
Main Methods:
- A pooled analysis of TAVR patient data from two tertiary centers was conducted.
- Incidence of MVCs was evaluated using multiple published definitions and compared against the Valve Academic Research Consortium (VARC) criteria.
- Inter-observer agreement was quantified using Kappa statistics.
Main Results:
- Major vascular complications ranged from 5.2% to 15.9% depending on the definition used.
- VARC criteria identified 9.0% major and 9.6% minor vascular complications.
- VARC definitions showed substantial agreement with SOURCE, UK, Italian, and FRANCE registries but moderate agreement with German and 18 Fr Safety and Efficacy study definitions.
Conclusions:
- Inconsistent definitions of vascular complications impede reliable comparisons between TAVR registries.
- Universal adoption of the VARC consensus document for standardized endpoint definitions is recommended for improved global TAVR outcome analysis.
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