Prophylactic Retrograde Distal Common Femoral Access as a Bail-out Strategy in Patients with Increased Risk for Femoral Access Complication During Transfemoral Aortic Valve Replacement
Highlights
- • Several patients undergoing TAVR have PAD that increases the risk of vascular closure device (VCD) failure.
- • In many such patients anatomic or clinical condition prohibits use of contralateral femoral access for rescuing the VCD failure.
- • We discuss a novel bailout technique for such patients.
- • The technique involves obtaining a prophylactic additional access in ipsilateral femoral artery distal to the TAVR access.
- • This technique provides an alternative endovascular bailout strategy for such patients.
Abstract
Objective
Several patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) have complex peripheral arterial disease (PAD) that increases risk of vascular complications and failure of vascular closure device (VCD). Endovascular bailout of failed VCD is performed through contralateral femoral access. Further due to multiple different anatomic reasons the contralateral femoral access and “up and over” approach is unavailable for endovascular bailout of the VCD failure. We evaluated a novel bailout technique of obtaining an additional access in ipsilateral common femoral artery (CFA) or superficial femoral artery (SFA) distal to the main CFA access used for TAVR device.