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Long-Term Outcomes of Iliofemoral Artery Stents after Transfemoral Aortic Valve Replacement
Authors:Yoni Grossman  Daniel Siverberg  Anat Berkovitch  Fernando Chernomordik  Arwa Younis  Elad Asher  Israel Barbash  Moshe Halak  Victor Guetta  Amit Segev  Paul Fefer
Affiliation:1. Leviev Heart Center, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel;2. Vascular Surgery Department, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
Abstract:

Purpose

To report long-term results of iliofemoral stent placement after transcatheter aortic valve replacement (TAVR).

Materials and Methods

TAVR access-related complications treated with iliofemoral stent placement were recorded in 56 patients (mean age, 81 years; range; 53–93 years; 48% male) of 648 patients who underwent TAVR at a single center. Fifty-six patients treated with stent placement (40 patients with stent grafts and 16 patients with bare metal stents) underwent clinical and ultrasonographic follow-up after a mean of 676 days (range, 60–1840 days).

Results

During follow-up, none of the 56 patients who had stent placement underwent a vascular reintervention of the affected limb, and none suffered from limb claudication. No decrease was observed in ankle-brachial index (ABI) values to an abnormal value, except in 1 patient (mean preprocedural and postprocedural ABI of 1.2 ± 0.14, range, 0.97–1.4 and 1.19 ± 0.24, range, 0.65–1.54, respectively). Arterial duplex assessment showed normal stent flow velocity (mean, 168.7 ± 63.2 cm/sec; range, 80–345 cm/sec) in all but 1 patient.

Conclusion

Iliofemoral stent implantation is a safe and efficacious treatment for vascular access site and access-related complications during transfemoral TAVR.
Keywords:ABI  ankle brachial index  CFA  common femoral artery  IMA  internal mammary artery  PVD  peripheral vascular disease  TAVR  transcatheter aortic valve replacement  VARC  valve academic research consortium
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