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SHR Neuro Cancer Cardio Lipid Metab Microb

Mach, M; Poschner, T; Hasan, W; Szalkiewicz, P; Andreas, M; Winkler, B; Geisler, S; Geisler, D; Rudzinski, PN; Watzal, V; Strouhal, A; Adlbrecht, C; Delle-Karth, G; Grabenwöger, M.
The Iliofemoral tortuosity score predicts access and bleeding complications during transfemoral transcatheter aortic valve replacement: DataData from the VIenna Cardio Thoracic aOrtic valve registrY (VICTORY)
EUR J CLIN INVEST. 2021; 51(6): e13491 Doi: 10.1111/eci.13491
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Co-authors Med Uni Graz: Andreas Martin
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Abstract:: Background: Arterial tortuosity is linked to a higher risk of adverse clinical events after transfemoral transcatheter aortic valve replacement (TF-TAVR). Currently, there are no assessment tools that can quantify this variable in three-dimensional space. This study investigated the impact of novel scoring methods of iliofemoral tortuosity on access and bleeding complications after TF-TAVR. Methods: The main access vessel was assessed between the aortoiliacal and femoral bifurcation in preoperative multislice computed tomography scans of 240 consecutive patients undergoing TF-TAVR. Tortuosity was assessed by three methods: largest single angle, sum of all angles, and iliofemoral tortuosity (IFT) score [((true vessel length/ideal vessel length)-1)*100]. The primary study endpoint was a composite of access and bleeding complications. The secondary study endpoints were 30-day mortality and long-term survival. Results: Among 240 patients, only the IFT score demonstrated a good positive correlation with the composite primary endpoint of access and bleeding complications (P = 0.031). A higher incidence of access and bleeding complications was found in patients with a higher IFT score (56 [36.8%] vs 17 [19.3%]; P = 0.003). In a multivariate logistic regression analysis, only the IFT score was a significant predictor of the primary endpoint (OR: 2.11; 95% CI: 1.09-4.05; P = 0.026). Conclusiom:Vascular tortuosity is an underestimated risk factor during TF-TAVR. The IFT score is a valuable tool in risk stratification before TF-TAVR, predicting periprocedural access and bleeding complications.
Find related publications in this database (Keywords): access; bleeding; TAVI; TAVR; tortuosity; transcatheter