Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions

Transcatheter aortic valve implantation (TAVI) is the usual technique for patients with severe aortic stenosis who are at high risk for surgical aortic valve replacement. The transfemoral (TF) route is the most commonly used access type, and significant progress in this procedure has greatly increas...

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Autores principales:	JJ Coughlan, Thomas J Kiernan, Samer Arnous
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2019
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ab4ac95e1ed24c6fb9b6b0ac8e7e6d38
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spelling	oai:doaj.org-article:ab4ac95e1ed24c6fb9b6b0ac8e7e6d382021-12-04T16:01:15ZAlternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions10.15420/ver.2019.4.22516-33022516-3299https://doaj.org/article/ab4ac95e1ed24c6fb9b6b0ac8e7e6d382019-01-01T00:00:00Zhttps://www.verjournal.com/articles/alternative-access-TAVIhttps://doaj.org/toc/2516-3299https://doaj.org/toc/2516-3302Transcatheter aortic valve implantation (TAVI) is the usual technique for patients with severe aortic stenosis who are at high risk for surgical aortic valve replacement. The transfemoral (TF) route is the most commonly used access type, and significant progress in this procedure has greatly increased the proportion of patients who can undergo it. Not all patients are suitable for TF TAVI, however, so other routes, including transapical, transaortic, subclavian, trans-subclavian/transaxillary, transcarotid and transcaval, may need to be used. Evidence on these routes shows promising results but the majority of this is registry data rather than randomised controlled trials, so TF TAVI remains the safest access route and should be considered for most patients. However, in patients who are unsuitable for TF TAVI, alternative access routes are safe and feasible. The challenges concern choosing the best route, the valve to use and skill of the specialist centre. This article provides a overview of options for alternative vascular access in TAVI, the clinical rationale for using them, current evidence and areas for clinical investigation.JJ CoughlanThomas J KiernanSamer ArnousRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENVascular and Endovascular Review , Vol 2, Iss 1, Pp 23-27 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 JJ Coughlan Thomas J Kiernan Samer Arnous Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
description	Transcatheter aortic valve implantation (TAVI) is the usual technique for patients with severe aortic stenosis who are at high risk for surgical aortic valve replacement. The transfemoral (TF) route is the most commonly used access type, and significant progress in this procedure has greatly increased the proportion of patients who can undergo it. Not all patients are suitable for TF TAVI, however, so other routes, including transapical, transaortic, subclavian, trans-subclavian/transaxillary, transcarotid and transcaval, may need to be used. Evidence on these routes shows promising results but the majority of this is registry data rather than randomised controlled trials, so TF TAVI remains the safest access route and should be considered for most patients. However, in patients who are unsuitable for TF TAVI, alternative access routes are safe and feasible. The challenges concern choosing the best route, the valve to use and skill of the specialist centre. This article provides a overview of options for alternative vascular access in TAVI, the clinical rationale for using them, current evidence and areas for clinical investigation.
format	article
author	JJ Coughlan Thomas J Kiernan Samer Arnous
author_facet	JJ Coughlan Thomas J Kiernan Samer Arnous
author_sort	JJ Coughlan
title	Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
title_short	Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
title_full	Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
title_fullStr	Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
title_full_unstemmed	Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions
title_sort	alternative access for transcatheter aortic valve implantation: current evidence and future directions
publisher	Radcliffe Medical Media
publishDate	2019
url	https://doaj.org/article/ab4ac95e1ed24c6fb9b6b0ac8e7e6d38
work_keys_str_mv	AT jjcoughlan alternativeaccessfortranscatheteraorticvalveimplantationcurrentevidenceandfuturedirections AT thomasjkiernan alternativeaccessfortranscatheteraorticvalveimplantationcurrentevidenceandfuturedirections AT samerarnous alternativeaccessfortranscatheteraorticvalveimplantationcurrentevidenceandfuturedirections
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Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions

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