000			03031nam a22004337a 4500
008			140403s20132013 xxu||||| |||| 00| 0 eng d
022			_a1774-024X
040			_aOvid MEDLINE(R)
099			_a24035884
245			_aImpact of low-profile sheaths on vascular complications during transfemoral transcatheter aortic valve replacement.
251			_aEurointervention. 9(8):929-35, 2013 Dec.
252			_aEuroIntervention. 9(8):929-35, 2013 Dec.
253			_aEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
266			_d2014-04-04
520			_aAIMS: We sought to assess the impact of low-profile sheaths on vascular complications during transfemoral transcatheter aortic valve replacement (TAVR).
520			_aCONCLUSIONS: The introduction of lower-profile sheaths has dramatically reduced the incidence of vascular complications after transfemoral TAVR, thus enhancing the safety of the procedure.
520			_aMETHODS AND RESULTS: This retrospective single-study population comprised a total of 375 consecutive patients with severe aortic stenosis who underwent transfemoral TAVR from January 2008 to November 2012. Of these, 204 (54.4%) underwent TAVR using 14-18 Fr sheaths (low-profile sheath [LPS] group), and 171 (45.6%) using 19-24 Fr sheaths (high-profile sheath [HPS] group). Vascular complications and bleeding were defined according to the VARC-2 definitions. Lower-profile sheaths were associated with a lower incidence of major vascular complications (0.5% vs. 10.5%, p<0.001), as well as a lower rate of life-threatening or major bleeding (3.4% vs. 8.3%, p=0.038). Finally, at multivariable analysis, sheath size >19 Fr (adjusted odds ratio [OR]: 3.06, 95% confidence interval [CI]: 1.20-7.83; p=0.019) and a sheath external diameter/minimal femoral artery diameter ratio >1.05 (adjusted OR: 5.79, 95% CI: 1.29-15.92, p=0.022) were found to be the only independent predictors of major and minor vascular complications.
546			_aEnglish
650			_a*Aortic Valve Stenosis/su [Surgery]
650			_a*Aortic Valve/su [Surgery]
650			_a*Cardiac Catheterization/ae [Adverse Effects]
650			_a*Femoral Artery/su [Surgery]
650			_a*Heart Valve Prosthesis Implantation
650			_a*Heart Valve Prosthesis/ae [Adverse Effects]
650			_aAged
650			_aAged, 80 and over
650			_aFemale
650			_aHeart Valve Prosthesis Implantation/mt [Methods]
650			_aHumans
650			_aMale
650			_aRetrospective Studies
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aDvir, Danny
790			_aBarbanti M, Binder RK, Cheung A, Dvir D, Freeman M, Lauck S, Leipsic J, Maryniak K, Tan J, Toggweiler S, Webb JG, Wood DA, Yang TH, Ye J
856			_uhttp://dx.doi.org/10.4244/EIJV9I8A156 _zhttp://dx.doi.org/10.4244/EIJV9I8A156
942			_cART _dJournal article
999			_c12227 _d12227