TY - JOUR
T1 - Transradial crossover balloon occlusion technique for primary access hemostasis during transcatheter aortic valve replacement
T2 - Initial experience with the oceanus 140 cm and 200 cm balloon catheters
AU - Junquera, Lucia
AU - Vilalta, Victoria
AU - Trillo, Ramiro
AU - Sabate, Manel
AU - Latib, Azeem
AU - Nombela-Franco, Luis
AU - Moris, Cesar
AU - Blanco, Bruno Garcia Del
AU - Larman, Mariano
AU - Hernandez, Jose Maria
AU - Iniguez, Andres
AU - Amat-Santos, Ignacio
AU - Fernandez-Nofrerias, Eduard
AU - Regueiro, Ander
AU - Colombo, Antonio
AU - Tzanis, Georgios
AU - Jimenez-Quevedo, Pilar
AU - Perez-Serranos, Isabel
AU - Duran-Priu, Marta
AU - Duocastella, Lluis
AU - Paradis, Jean Michel
AU - Cabau, Josep Rodes
N1 - Funding Information:
Funding: Dr Junquera was supported by a research grant from the Fundación Alfonso Martín Escudero (Madrid, Spain). Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions.
Funding Information:
Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Rodés-Cabau reports institutional research grants from Edwards Lifesciences and Medtronic. Dr Latib is a consultant for Edwards Lifesciences, Medtronic, and Abbott Vascular. Dr Nombe-la-Franco is a proctor for Abbott Vascular and reports speaker honoraria from Edwards Lifesciences. Dr Regueiro reports personal fees from Abbott Vascular and Cardiva. Dr Sabaté reports personal fees from Abbott Vascular and iVascular. The remaining authors report no conflicts of interest regarding the content herein.
PY - 2020/8
Y1 - 2020/8
N2 - 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.
AB - 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.
KW - Crossover balloon occlusion technique
KW - Radial access
KW - Secondary access
KW - Transcatheter aortic valve replacement
KW - Vascular complications
UR - http://www.scopus.com/inward/record.url?scp=85089128806&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089128806&partnerID=8YFLogxK
M3 - Article
C2 - 32737263
AN - SCOPUS:85089128806
VL - 32
SP - 283
EP - 288
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
SN - 1042-3931
IS - 8
ER -