Transradial crossover balloon occlusion technique for primary access hemostasis during transcatheter aortic valve replacement: Initial experience with the oceanus 140 cm and 200 cm balloon catheters

Lucia Junquera, Victoria Vilalta, Ramiro Trillo, Manel Sabate, Azeem Latib, Luis Nombela-Franco, Cesar Moris, Bruno Garcia Del Blanco, Mariano Larman, Jose Maria Hernandez, Andres Iniguez, Ignacio Amat-Santos, Eduard Fernandez-Nofrerias, Ander Regueiro, Antonio Colombo, Georgios Tzanis, Pilar Jimenez-Quevedo, Isabel Perez-Serranos, Marta Duran-Priu, Lluis DuocastellaJean Michel Paradis, Josep Rodes Cabau

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. The crossover balloon occlusion technique (CBOT) facilitates primary access hemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). The CBOT is usually performed through the contralateral femoral artery. The aim of this study was to evaluate, in patients undergoing TAVR, the safety and feasibility of transradial CBOT using the new Oceanus balloon dilatation catheter (iVascular). Methods. This multicenter study included 104 patients (mean age, 81 ± 7 years; 43% women) undergoing transfemoral TAVR. A modified CBOT through the radial artery was performed in all patients with the Oceanus balloon catheter. Data regarding transradial CBOT, balloon performance, vascular complications, and 30-day clinical events were recorded. Results. Up to 21% of patients had a height >170 cm and 17% presented with severe aortic/iliofemoral tortuosity. The transradial CBOT (left radial 74%, right radial 26%) was performed using either the 140 cm Oceanus (37.5%) or the 200 cm Oceanus (62.5%) balloon catheter. The balloon reached the femoral artery in all patients, and balloon inflation achieved an appropriate vessel closure in 98%. There were no complications related to the balloon catheter, and only 1 patient (1.0%) suffered a minor vascular complication related to the secondary radial access. The 30-day rates of primary access major vascular complications and death were 3.8% and 1.9%, respectively. Conclusion. In patients undergoing transfemoral TAVR, transradial CBOT with the Oceanus balloon dilatation catheter was feasible and safe. A balloon length up to 200 cm allowed the use of this technique (from right or left radial access) in all patients regardless of patient height or the presence of a challenging vascular anatomy.

Original languageEnglish (US)
Pages (from-to)283-288
Number of pages6
JournalJournal of Invasive Cardiology
Volume32
Issue number8
StatePublished - Aug 2020
Externally publishedYes

Keywords

  • Crossover balloon occlusion technique
  • Radial access
  • Secondary access
  • Transcatheter aortic valve replacement
  • Vascular complications

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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