Carotid versus femoral access for transcatheter ...
Document type :
Compte-rendu et recension critique d'ouvrage
DOI :
PMID :
Title :
Carotid versus femoral access for transcatheter aortic valve implantation a propensity score inverse probability weighting study
Author(s) :
Folliguet, Thierry A [Auteur correspondant]
CHU Henri Mondor [Créteil]
Teiger, Emmanuel [Auteur]
CHU Henri Mondor [Créteil]
Beurtheret, Sylvain [Auteur]
Modine, Thomas [Auteur]
Lefevre, Thierry [Auteur]
Van Belle, Eric [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Gilard, Martine [Auteur]
Eltchaninoff, Helene [Auteur]
Pharmacologie des Dysfonctionnements Endotheliaux et Myocardiques
Hôpital Charles Nicolle [Rouen]
Koning, René [Auteur]
Iung, Bernard [Auteur]
Verhoye, Jean Philippe [Auteur]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Leprince, Pascal [Auteur]
Sorbonne Université [SU]
CHU Pitié-Salpêtrière [AP-HP]
Le Breton, Hervé [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Lafont, Antoine [Auteur]
Paris-Centre de Recherche Cardiovasculaire [PARCC - UMR-S U970]
Parolari, Alessandro [Auteur]
Istituti di Ricovero e Cura a Carattere Scientifico [IRCCS]
Barili, Fabio [Auteur]
CHU Henri Mondor [Créteil]
Teiger, Emmanuel [Auteur]
CHU Henri Mondor [Créteil]
Beurtheret, Sylvain [Auteur]
Modine, Thomas [Auteur]
Lefevre, Thierry [Auteur]
Van Belle, Eric [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Gilard, Martine [Auteur]
Eltchaninoff, Helene [Auteur]
Pharmacologie des Dysfonctionnements Endotheliaux et Myocardiques
Hôpital Charles Nicolle [Rouen]
Koning, René [Auteur]
Iung, Bernard [Auteur]
Verhoye, Jean Philippe [Auteur]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Leprince, Pascal [Auteur]
Sorbonne Université [SU]
CHU Pitié-Salpêtrière [AP-HP]
Le Breton, Hervé [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Lafont, Antoine [Auteur]
Paris-Centre de Recherche Cardiovasculaire [PARCC - UMR-S U970]
Parolari, Alessandro [Auteur]
Istituti di Ricovero e Cura a Carattere Scientifico [IRCCS]
Barili, Fabio [Auteur]
Journal title :
European Journal of Cardio-Thoracic Surgery
Pages :
1140-1146
Publisher :
Oxford University Press (OUP)
Publication date :
2019-07-31
ISSN :
1010-7940
English keyword(s) :
Access site
Vascular complications
Carotid
Outcome
Aortic valve
Vascular complications
Carotid
Outcome
Aortic valve
HAL domain(s) :
Sciences du Vivant [q-bio]/Ingénierie biomédicale
English abstract : [en]
Objectives - The transcarotid (TC) approach for transcatheter aortic valve implantation (TAVI) is potentially an optimal alternative to the transfemoral (TF) approach. Our goal was to compare the safety and efficacy of TC- ...
Show more >Objectives - The transcarotid (TC) approach for transcatheter aortic valve implantation (TAVI) is potentially an optimal alternative to the transfemoral (TF) approach. Our goal was to compare the safety and efficacy of TC- and TF-TAVI. Methods - Patients who underwent TF-TAVI or TC-TAVI in the prospectively collected FRANCE TAVI registry between January 2013 and December 2015 were compared. Propensity score inverse probability weighting methods were employed to minimize the impact of bias related to non-random treatment assignment. Results - Of the 11 033 patients included in the current study, 10 598 (96%) underwent a TF-TAVI and 435 (4.1%) had a TC-TAVI. Patients in the TC-TAVI access group presented with a higher risk profile but were significantly younger. There were no differences in the perioperative and 2-year mortality rates after adjustment [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.62-1.68; P = 0.99 and hazard ratio 1.03, 95% CI 0.7-1.35; P = 0.83). TC-TAVI was associated with a significant risk of stroke (OR 2.42, 95% CI 2.01-2.92; P < 0.001), ST-elevation myocardial infarction (OR 7.32, 95% CI 3.87-13.87; P < 0.001), infections (OR 2.36, 95% CI 2.04-2.71; P < 0.001), bleeding (OR 2.01, 95% CI 1.76-2.29; P < 0.001), renal failure (OR 2.23, 95% CI 1.90-2.60; P < 0.001) and need for dialysis (OR 2.36, 95% CI 2.01-2.76, P < 0.001). Conversely, TC-TAVI was not confirmed as a risk factor for pacemaker implantation after adjustment (OR 1.05, 95% CI 0.96-1.15; P < 0.28) and was a protective factor for vascular complications (OR 0.37, 95% CI 0.32-0.43; P < 0.001). Conclusions - TC-TAVI is a safe procedure compared to TF-TAVI, although it holds an increased risk of perioperative complications. It should be considered in case of non-femoral peripheral access as the second access choice, to increase the overall safety of TAVI procedures.Show less >
Show more >Objectives - The transcarotid (TC) approach for transcatheter aortic valve implantation (TAVI) is potentially an optimal alternative to the transfemoral (TF) approach. Our goal was to compare the safety and efficacy of TC- and TF-TAVI. Methods - Patients who underwent TF-TAVI or TC-TAVI in the prospectively collected FRANCE TAVI registry between January 2013 and December 2015 were compared. Propensity score inverse probability weighting methods were employed to minimize the impact of bias related to non-random treatment assignment. Results - Of the 11 033 patients included in the current study, 10 598 (96%) underwent a TF-TAVI and 435 (4.1%) had a TC-TAVI. Patients in the TC-TAVI access group presented with a higher risk profile but were significantly younger. There were no differences in the perioperative and 2-year mortality rates after adjustment [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.62-1.68; P = 0.99 and hazard ratio 1.03, 95% CI 0.7-1.35; P = 0.83). TC-TAVI was associated with a significant risk of stroke (OR 2.42, 95% CI 2.01-2.92; P < 0.001), ST-elevation myocardial infarction (OR 7.32, 95% CI 3.87-13.87; P < 0.001), infections (OR 2.36, 95% CI 2.04-2.71; P < 0.001), bleeding (OR 2.01, 95% CI 1.76-2.29; P < 0.001), renal failure (OR 2.23, 95% CI 1.90-2.60; P < 0.001) and need for dialysis (OR 2.36, 95% CI 2.01-2.76, P < 0.001). Conversely, TC-TAVI was not confirmed as a risk factor for pacemaker implantation after adjustment (OR 1.05, 95% CI 0.96-1.15; P < 0.28) and was a protective factor for vascular complications (OR 0.37, 95% CI 0.32-0.43; P < 0.001). Conclusions - TC-TAVI is a safe procedure compared to TF-TAVI, although it holds an increased risk of perioperative complications. It should be considered in case of non-femoral peripheral access as the second access choice, to increase the overall safety of TAVI procedures.Show less >
Language :
Anglais
Popular science :
Non
Source :
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