Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study
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Peripheral intravascular lithotripsy for transcatheter aortic valve implantation : a multicentre observational study. / Nardi, Giulia; De Backer, Ole; Saia, Francesco; Søndergaard, Lars; Ristalli, Francesca; Meucci, Francesco; Stolcova, Miroslava; Mattesini, Alessio; Demola, Pierluigi; Wang, Xi; Al Jabri, Anees; Palmerini, Tullio; Bruno, Antonio Giulio; Ielasi, Alfonso; Van Belle, Eric; Berti, Sergio; Di Mario, Carlo.
I: EuroIntervention, Bind 17, Nr. 17, 2022, s. E1397-E1406.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Peripheral intravascular lithotripsy for transcatheter aortic valve implantation
T2 - a multicentre observational study
AU - Nardi, Giulia
AU - De Backer, Ole
AU - Saia, Francesco
AU - Søndergaard, Lars
AU - Ristalli, Francesca
AU - Meucci, Francesco
AU - Stolcova, Miroslava
AU - Mattesini, Alessio
AU - Demola, Pierluigi
AU - Wang, Xi
AU - Al Jabri, Anees
AU - Palmerini, Tullio
AU - Bruno, Antonio Giulio
AU - Ielasi, Alfonso
AU - Van Belle, Eric
AU - Berti, Sergio
AU - Di Mario, Carlo
N1 - Publisher Copyright: © Europa Digital & Publishing 2022. All rights reserved. SU
PY - 2022
Y1 - 2022
N2 - Background: The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve implantation (TAVI) by the transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium and increases vessel compliance allowing TF TAVI in selected patients with peripheral artery disease (PAD). Aims: The aim of this study was to report on the safety and efficacy of IVL-assisted TF TAVI in an all-comers population. Methods: Clinical, imaging and procedural data on all consecutive patients treated by IVL-assisted TF TAVI in six high-volume European centres (2018-2020) were collected in this prospective, real-world, multicentre registry. Results: IVL-assisted TF TAVI was performed in 108 patients, increasing from 2.4% to 6.5% of all TAVI from 2018 to 2020, respectively. The target lesion was most often localised at the common and/or external iliac artery (93.5% of cases; average TL-MLD 4.6±0.9 mm with 318 degrees of calcium arc). Transfemoral aortic valve delivery was successful in 100% of cases; final procedural success in 98.2% (two conversions to cardiac open surgery for annular rupture and valve migration). Complications of the IVL-treated segments consisted of 1 perforation and 3 major dissections requiring stent implantation (2 covered stents and 2 BMS). Access-site-related complications included 3 major bleedings. Three in-hospital deaths were recorded (2.8%, 1 failed surgical conversion after annular rupture, 1 cardiac arrest after initial valvuloplasty, 1 late hyperkalaemia in renal dysfunction). Conclusions: IVL-assisted TF TAVI proved to be a safe and effective approach, which helps to expand the indications for TF TAVI in patients with severe calcific PAD. However, these patients continue to have a higher-than-average incidence of periprocedural complications.
AB - Background: The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve implantation (TAVI) by the transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium and increases vessel compliance allowing TF TAVI in selected patients with peripheral artery disease (PAD). Aims: The aim of this study was to report on the safety and efficacy of IVL-assisted TF TAVI in an all-comers population. Methods: Clinical, imaging and procedural data on all consecutive patients treated by IVL-assisted TF TAVI in six high-volume European centres (2018-2020) were collected in this prospective, real-world, multicentre registry. Results: IVL-assisted TF TAVI was performed in 108 patients, increasing from 2.4% to 6.5% of all TAVI from 2018 to 2020, respectively. The target lesion was most often localised at the common and/or external iliac artery (93.5% of cases; average TL-MLD 4.6±0.9 mm with 318 degrees of calcium arc). Transfemoral aortic valve delivery was successful in 100% of cases; final procedural success in 98.2% (two conversions to cardiac open surgery for annular rupture and valve migration). Complications of the IVL-treated segments consisted of 1 perforation and 3 major dissections requiring stent implantation (2 covered stents and 2 BMS). Access-site-related complications included 3 major bleedings. Three in-hospital deaths were recorded (2.8%, 1 failed surgical conversion after annular rupture, 1 cardiac arrest after initial valvuloplasty, 1 late hyperkalaemia in renal dysfunction). Conclusions: IVL-assisted TF TAVI proved to be a safe and effective approach, which helps to expand the indications for TF TAVI in patients with severe calcific PAD. However, these patients continue to have a higher-than-average incidence of periprocedural complications.
KW - aortic stenosis
KW - femoral
KW - TAVI
U2 - 10.4244/EIJ-D-21-00581
DO - 10.4244/EIJ-D-21-00581
M3 - Journal article
C2 - 34734559
AN - SCOPUS:85128159899
VL - 17
SP - E1397-E1406
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 17
ER -
ID: 313772002