Tag Archives: femoral access


TAVR: Should Transradial Approach be the Second Access Site?

TAVR: Should Transradial Approach be the Second Access Site?

Courtesy of Dr. Carlos Fava. One of the major challenges we interventional cardiologists still face is access management. Reduced device diameter and improved transcatheter closure, together with increased operator experience, have significantly reduced vascular complications. However, we shouldn’t lose sight of the secondary access, usually transfemoral, generally used in case of primary access site related

Subclavian and Axillary Access for TAVR: a Valid Alternative

Courtesy of Dr. Carlos Fava. The femoral approach is preferred when it comes to TAVR, but sometimes it is not viable. This is when other access sites come into play, such as the trans-subclavian/axillary (TS/TAx), the apical, transcaval, transcarotid (TC) or transaortic. At present, few studies have looked into this matter, which is why it


Transcaval Access Is Safe in TAVR

Courtesy of Dr. Carlos Fava. One of the limitations to percutaneous interventions is poor or impossible femoral access. This happens especially in TAVR, with endoprosthesis or ventricular assistance devices, when the transcaval approach with cardiac occluder rises as a viable alternative. We have started to use it in TAVR, but at present there is little


Transcarotid Approach for Transfemoral in TAVR

Courtesy of Dr. Carlos Fava. At present, the transfemoral is the preferred access site in TAVR, for it has been shown to present fewer complications. However, whenever not feasible, we can resort to other approaches. These include the subclavian, the transapical, the transcaval, the transaortic, and the transcarotid. This last one has been studied few

Successful CTO Reduces Local and Remote Residual Ischemia

CTO: in Radial Access with Similar Results to Femoral

Courtesy of Dr. Carlos Fava. One of the characteristics of chronic total occlusion (CTO) is the use of two access routes: femoral and radial. The radial approach is safer, but it has not been thoroughly analyzed in this type of PCI. The study looked at 3709 patients undergoing left main percutaneous coronary intervention (PCI) for

El acceso radial reduce el riesgo de insuficiencia renal en pacientes agudos

The transradial approach reduces the risk of kidney injury in acute patients

It remains unclear whether transradial access, compared with transfemoral access, presents a different risk of post-procedural kidney injury for patients admitted with acute coronary syndrome. Historically, it has been considered (without any evidence) that, given the higher difficulty associated with transradial access, it would require longer fluoroscopy time and higher contrast volume, which would eventually

Transradial access shows no benefit of bivalirudin

The aim of this study was to compare bivalirudin against heparin in patients with ST elevation acute myocardial infarction undergoing transradial primary PCI.   Both bivalirudin and the transradial access are strategies aimed at reducing bleeding complications in patients undergoing acute MI. However, the benefit of their combined use is not year clear. Even though

dispositivo de cierre manta en acceso femoral

MANTA Closure Device for large-bore arteriotomy closure: Is It Safe?

 Courtesy of Dr. Agustín Vecchia.  The number of transcatheter aortic valve replacements (TAVR) and the placement of aortic endoprosthesis and ventricular assist devices, among others, have grown exponentially worldwide in the last few years. In a short time, many of these procedures will surely become the new standard of care. Logically, this growth comes hand in hand

acceso transcaval tavi

Transcaval Access: Another Alternative to Femoral Access Counterindication

For TAVR eligible patients (transcatheter aortic valve replacement) with femoral access counterindication, a new access site, extra thoracic yet percutaneous, may offer an alternative. This consists of reaching the abdominal aorta through the vena cava.   With this technique the operator enters the abdominal aorta through the vena cava by electrifying a guidewire, advancing a

cierre percutaneo femoral

Closure Devices vs. Manual Compression

Courtesy of Dr. Guillermo Migliaro.   Post PCI major bleeding has been associated with short term mortality in acute coronary syndromes (ACS). Even though studies have shown the transradial approach is safer than the femoral, especially in high risk subgroups ─ mainly STEMI patients ─ the femoral access site continues to be widely used.