Incidence and Predictors of Access Site Vascular Complications Following Ultrasound-Guided MANTA Closure Deployment

被引:5
|
作者
Miyashita, Hirokazu [1 ,2 ,3 ]
Moriyama, Noriaki [3 ]
Laine, Mika [1 ,2 ]
机构
[1] Univ Helsinki, Heart & Lung Ctr, Dept Cardiol, Haartmaninkatu 4, Helsinki 00290, Finland
[2] Univ Helsinki, Cent Hosp, Haartmaninkatu 4, Helsinki 00290, Finland
[3] Shonan Kamakura Gen Hosp, Dept Cardiol & Catheterizat Labs, Kamakura, Kanagawa, Japan
关键词
vascular complication; vascular closure devices; aortic stenosis; AORTIC-VALVE IMPLANTATION; PERCUTANEOUS ACCESS; MINIMALIST APPROACH; MULTICENTER; CRITERIA; OUTCOMES; DEVICE;
D O I
10.1177/15266028211059446
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: There is no report on the reproducibility of the ultrasound-navigated MANTA deployment (US-MANTA) technique and little is known about predictors for US-MANTA-related vascular complication (VC). This study aimed to assess the incidence and predictors of access-site VC using the US-MANTA technique and report insights of MANTA-related VC from consecutive cases following large-bore arteriotomy. Materials and Methods: Consecutive patients who underwent transfemoral transcatheter aortic valve replacement with the US-MANTA technique from November 2018 to February 2020 were evaluated. MANTA-related VC was defined as access-site complications leading to major or minor VCs based on Valve Academic Research Consortium-2 criteria. Results: Among 378 patients, 23 cases (6.1%) of MANTA-related VC (major VC: n=7 [1.9%], minor VC: n=16 [4.2%]) were identified. No significant difference was observed in the incidence of MANTA-related VC over the observational period (first quartile: 5.3%, second: 5.4%, third: 7.4%, and fourth: 6.3%, p>.50). In 7 patients with MANTA-related major VC, 4 (57.1%) of complications resulted from incomplete apposition of the toggle due to anterior wall calcification of the common femoral artery (CFA). Anterior calcification of the CFA determined by computed tomography was identified as an independent predictor of MANTA-related VCs. Conclusions: The US-MANTA technique sustainably provides a low rate of access-site VCs following large-bore arteriotomy. Incomplete apposition of the toggle due to anterior calcification of the CFA may lead to ongoing vascular and bleeding complications.
引用
收藏
页码:576 / 585
页数:10
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