TY - JOUR

T1 - Long-term follow-up after stent graft placement for access-site and access-related vascular injury during TAVI - The Bonn-Copenhagen experience

AU - Sedaghat, Alexander

AU - Hansen, Kristoffer Lindskov

AU - Schahab, Nadjib

AU - May, Maria Cesarina

AU - Weber, Marcel

AU - Stundl, Anja

AU - Shamekhi, Jasmin

AU - Schaefer, Christian

AU - Nickenig, Georg

AU - Sinning, Jan-Malte

AU - Lönn, Lars

AU - Søndergaard, Lars

AU - Werner, Nikos

AU - De Backer, Ole

N1 - Copyright © 2019 Elsevier B.V. All rights reserved.

PY - 2019/4/15

Y1 - 2019/4/15

N2 - AIMS: Stent graft placement is a safe and effective treatment option for vascular complications in the context of transcatheter aortic valve implantation (TAVI). This study aimed to provide long-term angiological follow-up of stent grafts used for this indication.METHODS AND RESULTS: Seventy-one patients (64.8% female, log EuroScore 14.7 ± 6.8%) who had undergone TAVI between March 2010 and October 2015 with implantation of a Viabahn or Fluency stent graft to treat access-site or access-related vascular injury (ASARVI) were analyzed. Implantations were mostly due to access-site bleeding complications (83.1%) in the common femoral artery (97.1%). Follow-up was performed with duplex sonography in all patients after a median of 3.9 years after TAVI (interquartile range [IQR]: 895-1749 days). Ultrasound revealed tri- or biphasic flow patterns in 16.9% and 77.6%, respectively. Stent graft patency was 100% without signs of stent graft stenosis (mean peak velocity ratio 1.0 ± 0.2). Pseudo-aneurysms or endoleaks were diagnosed in 5.6% of patients. Additional fluoroscopic and/or computed tomography (CT)-imaging was available in 36.6% of patients and did not reveal any stent fracture.CONCLUSION: Self-expanding stent grafts provide excellent long-term function with few complications when implanted in the context of TAVI-related ASARVI.

AB - AIMS: Stent graft placement is a safe and effective treatment option for vascular complications in the context of transcatheter aortic valve implantation (TAVI). This study aimed to provide long-term angiological follow-up of stent grafts used for this indication.METHODS AND RESULTS: Seventy-one patients (64.8% female, log EuroScore 14.7 ± 6.8%) who had undergone TAVI between March 2010 and October 2015 with implantation of a Viabahn or Fluency stent graft to treat access-site or access-related vascular injury (ASARVI) were analyzed. Implantations were mostly due to access-site bleeding complications (83.1%) in the common femoral artery (97.1%). Follow-up was performed with duplex sonography in all patients after a median of 3.9 years after TAVI (interquartile range [IQR]: 895-1749 days). Ultrasound revealed tri- or biphasic flow patterns in 16.9% and 77.6%, respectively. Stent graft patency was 100% without signs of stent graft stenosis (mean peak velocity ratio 1.0 ± 0.2). Pseudo-aneurysms or endoleaks were diagnosed in 5.6% of patients. Additional fluoroscopic and/or computed tomography (CT)-imaging was available in 36.6% of patients and did not reveal any stent fracture.CONCLUSION: Self-expanding stent grafts provide excellent long-term function with few complications when implanted in the context of TAVI-related ASARVI.

KW - Aged

KW - Aged, 80 and over

KW - Blood Vessel Prosthesis/adverse effects

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Stents/adverse effects

KW - Time Factors

KW - Tomography, X-Ray Computed/trends

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

KW - Vascular System Injuries/diagnostic imaging

U2 - 10.1016/j.ijcard.2018.12.053

DO - 10.1016/j.ijcard.2018.12.053

M3 - Journal article

C2 - 30711261

VL - 281

SP - 42

EP - 46

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -