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Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter

Elliott J Carande1, Tarik S Salim2, Alexander Chase2

  • 1Cwm Taff Morgannwg University Health Board, Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom.

The British Journal of Radiology
|September 25, 2023
PubMed

Insights

Vascular complications after transcatheter aortic valve implantation (TAVI) are common. CT angiography plaque analysis identifying necrotic core volume in the common femoral artery can predict these TAVI complications.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Vascular and bleeding complications are frequent after transcatheter aortic valve implantation (TAVI), increasing patient morbidity and mortality.
  • Predicting these complications is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate demographic and procedural risk factors for Valve Academic Research Consortium (VARC-3) vascular complications in transfemoral TAVI.
  • To assess the predictive capability of pre-procedure femoral CT angiography, including plaque composition analysis, for TAVI-related vascular complications.

Main Methods:

  • Retrospective cohort study of 299 patients undergoing transfemoral TAVI with vascular closure devices (ProGlide or MANTA).
  • Analysis of common femoral artery plaque composition using CT angiography and novel plaque map quantification.
  • Investigation of associations between demographic factors, procedural details, and VARC-3 vascular complications.

Main Results:

  • Vascular complications occurred in 7.7% of patients (23/299).
  • No demographic risk factors or differences between closure devices were associated with complications.
  • Sheath size (OR 1.36) and CT-derived necrotic core volume (OR 17.49) were associated with vascular complications.

Conclusions:

  • Plaque map analysis of the common femoral artery via CT angiography indicates that greater necrotic core volume increases the risk of VARC-3 vascular complications.
  • Novel CT-derived measurement of necrotic core volume predicts post-TAVI vascular complications, aiding in risk stratification.
Abstract

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