Grossman Yoni, Silverberg Daniel, Berkovitch Anat, Chernomordik Fernando, Younis Arwa, Asher Elad, Barbash Israel, Halak Moshe, Guetta Victor, Segev Amit, Fefer Paul
Leviev Heart Center, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
Vascular Surgery Department, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
J Vasc Interv Radiol. 2018 Dec;29(12):1733-1740. doi: 10.1016/j.jvir.2018.06.003. Epub 2018 Oct 5.
To report long-term results of iliofemoral stent placement after transcatheter aortic valve replacement (TAVR).
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).
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.
Iliofemoral stent implantation is a safe and efficacious treatment for vascular access site and access-related complications during transfemoral TAVR.
报告经导管主动脉瓣置换术(TAVR)后髂股动脉支架置入的长期结果。
在单中心接受TAVR的648例患者中,记录了56例(平均年龄81岁;范围53 - 93岁;48%为男性)因TAVR入路相关并发症接受髂股动脉支架置入的患者。56例行支架置入治疗的患者(40例使用覆膜支架,16例使用裸金属支架)在平均676天(范围60 - 1840天)后接受了临床和超声随访。
随访期间,56例接受支架置入的患者中无一例对患侧肢体进行血管再次干预,也无一例出现肢体间歇性跛行。除1例患者外,踝臂指数(ABI)值未降至异常水平(术前和术后平均ABI分别为1.2±0.14,范围0.97 - 1.4和1.19±0.24,范围0.65 - 1.54)。动脉双功超声评估显示,除1例患者外,所有患者支架内血流速度正常(平均168.7±63.2 cm/秒;范围80 - 345 cm/秒)。
髂股动脉支架植入术是治疗经股动脉TAVR期间血管入路部位及入路相关并发症的一种安全有效的方法。