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Sticchi et al. Vessel Plus 2018;2:23 Vessel Plus
DOI: 10.20517/2574-1209.2018.47

Review Open Access

Vascular approaches and its potential implications
in transcatheter aortic valve implantation

Alessandro Sticchi, Edoardo Bressi, Annunziata Nusca, Germano Di Sciascio
Unit of Cardiovascular Science, Campus Bio-Medico University, Rome 00128, Italy.

Correspondence to: Dr. Alessandro Sticchi, Unit of Cardiovascular Science, Campus Bio-Medico University, Rome 00128, Italy.
E-mails: sticchialessandro@gmail.com; a.sticchi@unicampus.it

How to cite this article: Sticchi A, Bressi E, Nusca A, Di Sciascio G. Vascular approaches and its potential implications in
transcatheter aortic valve implantation. Vessel Plus 2018;2:23. http://dx.doi.org/10.20517/2574-1209.2018.47

Received: 20 Jun 2018 First Decision: 17 Jul 2018 Revised: 15 Aug 2018 Accepted: 17 Aug 2018 Published: 13 Sep 2018
Science Editors: Mario F. L. Gaudino, Cristiano Spadaccio Copy Editor: Yuan-Li Wang Production Editor: Huan-Liang Wu

Abstract
Transcatheter aortic valve implantation (TAVI) has become in the last years a primary therapeutic tool in order to treat
percutaneously severe aortic stenosis in frail patients with multiple comorbidity and a high surgical risk. In almost all
cases, the complexity of patients who are candidates for TAVI is also reflected in challenging access sites. This vascular
issue addresses the invasive play of constantly evolving devices and resulting complications have a considerable impact
on patient morbidity and mortality. For this reason, the study and the choice of the different access site require the
attention and experience of the operators to reach the most reliable and feasible vascular approach for a real procedural
success.

Keywords: Transcatheter aortic valve implantation, vascular access site, access complications

INTRODUCTION
The transcatheter implantation of the aortic valve is confirmed as a rapidly expanding treatment for severe
[1]
aortic stenosis in patients with a great risk in terms of mortality to undergo cardiac surgery . At the begin-
ning of this experience, a considerable size of sheaths and catheters required a real surgical access for the
device insertion, later with the advancement of the technique, the percutaneous approach became more and
[2]
more common because of its less invasive characteristics . However, these procedures are burdened by a
significant risk of vascular complications that represent an element of criticality in transcatheter aortic valve
[3]
implantation (TAVI) performance and are related with adverse events and mortality . In fact, these patients
are predisposed to high procedural and bleeding risk due to challenging interventions, such as vascular ac-
[3]
cess damage for larger devices but also vessels morbidities and patient frailty . The TAVI through femoral

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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