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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Management of vascular access in transcatheter aortic valve replacement: part 2: Vascular complications

Stefan Toggweiler1, Jonathon Leipsic, Ronald K Binder

  • 1St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

JACC. Cardiovascular Interventions
|August 24, 2013
PubMed

Insights

Recognizing and managing vascular complications, particularly iliofemoral ones in transcatheter aortic valve implantation, is crucial for interventional cardiologists. Endovascular techniques offer less invasive options for managing arterial injuries and ruptures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Vascular complications are a significant concern in interventional cardiology procedures.
  • Transfemoral transcatheter aortic valve implantation (TAVI) is associated with frequent iliofemoral complications.
  • Predictors include small vessel size, calcification, and procedural experience.

Purpose of the Study:

  • To outline the recognition and management strategies for vascular complications during interventional cardiology procedures.
  • To highlight the prevalence and predictors of iliofemoral complications in TAVI.
  • To discuss evolving treatment options, including endovascular techniques.

Main Methods:

  • Review of current literature and clinical practices for managing vascular complications.
  • Analysis of predictors for iliofemoral complications in TAVI.
  • Description of treatment algorithms for various arterial injuries and ruptures.

Main Results:

  • Iliofemoral complications are the most common vascular issues in transfemoral TAVI.
  • Small vessel dimensions, calcification, and center experience are key predictors.
  • Endovascular techniques provide less invasive alternatives to surgical reconstruction for arterial injuries.

Conclusions:

  • Effective management of vascular complications requires prompt recognition and appropriate intervention.
  • Endovascular approaches are increasingly viable for treating TAVI-related arterial injuries.
  • Awareness of complications associated with alternative access routes is also important.

Keywords:
TAVIVARCValve Academic Research Consortiumaortic stenosiscomplicationstranscatheter aortic valve implantationtranscatheter aortic valve replacement

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