Service de médecine intensive - réanimation, Hôpitaux universitaires Paris-Saclay, Hôpital de Bicêtre, APHP, Le Kremlin-Bicêtre, France.
Inserm UMR S_999, Univ Paris-Saclay, Le Kremlin-Bicêtre, France.
Scand Cardiovasc J. 2021 Oct;55(5):297-299. doi: 10.1080/14017431.2021.1970802. Epub 2021 Aug 27.
Acute kidney injury (AKI) is a common postoperative complication after transcatheter aortic valve replacement (TAVR). In patients with ineligible femoral access, transaxillary/subclavian (TAx/TSc) might be competitive alternative access. With nine cohort studies and 4995 patients, we found that TAx/TSc access was associated with decreased incidences of AKI (Relative risk [RR]: 0.573, 95% confidence interval [CI]:0.456-0.718, < .001) and stage 3 AKI (RR 0.460, 95%CI 0.318-0.665, < .001) by comparison with intrathoracic approaches. Our findings suggest that TAx/TSc is associated with a reduced AKI risk after TAVR in patients with impossible femoral access.
急性肾损伤（AKI）是经导管主动脉瓣置换术（TAVR）后的常见术后并发症。在股动脉入路不合适的患者中，经腋/锁骨下（TAx/TSc）可能是一种有竞争力的替代入路。通过 9 项队列研究和 4995 例患者，我们发现与经胸入路相比，TAx/TSc 入路与 AKI 发生率降低相关（相对风险 [RR]：0.573，95%置信区间 [CI]：0.456-0.718， < .001）和 3 期 AKI（RR 0.460，95%CI 0.318-0.665， < .001）。我们的研究结果表明，在股动脉入路不可能的患者中，TAx/TSc 与 TAVR 后 AKI 风险降低相关。
