Femoral or Radial Secondary Access in TAVR

Femoral or Radial Secondary Access in Transcatheter Aortic Valve Replacement (TAVR)

JACC Cardiovasc IntervPublished 23 Dec 2024

Authors' conclusion

During transfemoral TAVR, TR-SA was associated with lower rates of access site complications and severe bleeding compared to TF-SA.

Population: Patients undergoing transfemoral TAVR at 10 heart centres, 2016–2021 (PULSE registry)of 10,120 in registry
Participants: 8,851 patients

Exposure: Transradial secondary access (TR-SA) vs traditional femoral secondary access (TF-SA)
TR-SAn = 1,686
TF-SAn = 7,165reference
Outcome: Secondary access-related vascular complications (VARC-3)

As reported in the abstract

Secondary access vascular complications

TR-SA0.3%5 of 1,686

TF-SA3.2%232 of 7,165

P < 0.001

Observational data: associations, not effects.

Major secondary access vascular complications

P < 0.001

TR-SA0.2%

TF-SA1.5%

Minor secondary access vascular complications

P < 0.001

TR-SA0.1%

TF-SA1.7%

Secondary access vascular complications, propensity-matched

P < 0.001

TR-SA0.2%

TF-SA2.9%

Secondary access vascular complications, propensity-matched: matched cohort (1:1, 512 per group)

Primary access vascular complications

P = 0.93

TR-SA11.6%

TF-SA11.5%

Bleeding type III/IV

P < 0.001

TR-SA2.5%

TF-SA4.7%

Outcome	TR-SA	TF-SA	P value
Surgical repair required	0 events	0.9%

Femoral or Radial Secondary Access in TAVR. JACC Cardiovasc Interv. Published 23 December 2024. doi:10.1016/j.jcin.2024.09.020

Summarised from the published abstract; every number is checked against it