Valvular & structural heart diseaseResearch article
Safety of Selective and Routine Femoral Access Angiography Post-Transcatheter Aortic Valve Implantation
- retrospectively analyzed
- 2 sites of a single center
Authors' conclusion
Routine angiography increases detection of minor vascular abnormalities, while selective angiography guided by clinical suspicion may provide comparable clinical outcomes. Routine postprocedural angiography may be unnecessary in many patients. Prospective randomized studies are needed to determine the optimal surveillance strategy.
Study context
- Population
- Patients undergoing transfemoral transcatheter aortic valve implantation (TF-TAVI)Routine angiography site 674 · Selective strategy site 473
- Participants
- 1,147 TF-TAVI procedures
- Comparison
- routine and selective postprocedural iliofemoral angiography after TF-TAVI
- routinen = 674reference
- selectiven = 473
Main finding
Vascular and access-site complications (VARC-3)
Odds ratio
0.76
95% CI 0.48–1.19
By group
As reported in the abstract
Further findings
Access-site bleedings detected
- Access-site bleedings detected: P < 0.001
Access-site bleedings detected
- No differences in hemoglobin drop, transfusion due to access-site bleeding, or bleeding-related death
Overall vascular reinterventions
- Overall vascular reinterventions comparable
- 4.2% vs 6.5%
- More catheter-based interventions in the routine strategy and more surgical/thrombin-based interventions in the selective strategy
- P = 0.095
Adjusted and inverse probability of treatment weights-weighted analyses
- Bleeding complications remained lower with the selective strategy, whereas overall VARC-3 complications did not differ
- Angiography strategy not associated with acute kidney injury despite higher total contrast in the routine group
Original publication
Summarised from the published abstract; every number is checked against it