Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access fails. The introduction of ultrasound (US) to guide access has emerged as a technique that allows for precise channeling, avoiding accesses above or below the inguinal ligament. However, evidence regarding the use of this tool has shown diverse results. Two surveys conducted...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access is not successful. The use of ultrasound (US) to guide access has emerged as a technique that allows for precise cannulation, avoiding accesses above and below the inguinal ligament. However, evidence regarding the effectiveness of this tool has shown variable results. Two...
Transulnar access can be as safe and effective as transradial access, and it is a particularly good alternative for the preservation of radial artery patency or when such vessel presents a difficult anatomy. This new meta-analysis that will be published soon in Catheter Cardiovasc Interv showed a relatively high failure rate for that access, but...
Original Title: Transfemoral Access Assessment for Transcatheter Aortic Valve Replacement Evidence Based Application of Computed Tomography over Invasive Angiography. Reference: Circ Cardiovas Imaging 2015 DOI:10.1161/CIRCIMAGING.114.0011995. Courtesy of Dr. Guillermo Migliaro Transfemoral access for TAVI was introduced in 2006 and is considered first choice. Vascular complications (VCs) are important events that correlate to increased mortality. According to the...
Transcatheter aortic valve replacement (TAVR) through transfemoral access has already proven its great benefits, but this access cannot be used in certain patients, and alternative accesses need to be considered for such cases. One of the most commonly used accesses is the transaxillary or transubclavian access (AX), which, however, is associated with more complications (especially...
The first experiences with distal radial access (DRA) have revealed significant benefits compared against the transradial approach (TRA), showing reduced bleeding events and better puncture site occlusion rate. Even the spectrum of diseases treated with DRA has grown, and now includes chronic total occlusion (CTO) though 7Fr inductors, such as Terumo’s Glidesheath Slender. The aim...
One of the challenges that transcatheter aortic valve replacement (TAVR) continues to face is percutaneous access closure with percutaneous closure systems (PCS). However, several systems have been developed, either by plug—such as the MANTA system—or by suture (SU)—such as the ProStar and ProGlide systems. Both of these have been tested in different analyses, but to...
At present, the transfemoral access (TFA) is the preferred approach when it comes to transcatheter aortic valve replacement (TAVR). However, 5 to10% of PAD patients present tortuous iliac anatomy and calcification, aortic aneurysms or prior peripheral intervention, which makes it impossible. There are several alternatives to approach these patients: 1) TFA associated to peripheral PCI...
In 1992, Kiemeneij performed the first transradial coronary procedure, following Campeau’s description of that access in 1989. It’s been 30 years since that milestone in interventional cardiology. Over time, the number of procedures conducted with this approach has increased exponentially, and it is the main approach in most centers in different clinical scenarios. Historically, the...
Angioplasty by transradial access was discussed during a session on Day 2. We were pleased to participate in a conference by Dr. Shigeru Saito on distal radial access. Currently, complications associated with transfemoral access are well-established, so transradial access is suggested as the initial strategy in several guidelines of various associations. However, Dr. Saito shared...