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

Abstract

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.

• Authors: Alexander Sedaghat, Kristoffer Lindskov Hansen, Nadjib Schahab, Maria Cesarina May, Marcel Weber, Anja Stundl, Jasmin Shamekhi, Christian Schaefer, Georg Nickenig, Jan-Malte Sinning, Lars Lönn, Lars Søndergaard, Nikos Werner, Ole De Backer
• Journal: International journal of cardiology (Int J Cardiol) Vol. 281 Pg. 42-46 (04 15 2019) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 30711261 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2019 Elsevier B.V. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Blood Vessel Prosthesis (adverse effects, trends)
• Cohort Studies
• Cross-Sectional Studies
• Female
• Follow-Up Studies
• Humans
• Male
• Stents (adverse effects, trends)
• Time Factors
• Tomography, X-Ray Computed (trends)
• Transcatheter Aortic Valve Replacement (adverse effects, trends)
• Treatment Outcome
• Vascular System Injuries (diagnostic imaging, epidemiology)