Evidence map›Paper›PMID 32030231›Full record

ArticleJournal of thoracic disease2019

A meta-analysis comparing transaxillary and transfemoral transcatheter aortic valve replacement.

Yong Zhan, Siavash Saadat, Avneet Soin, Masashi Kawabori, Frederick Y Chen

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Non-femoral focused transaxillary access in TAVI: GARY data analysis and future trends.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Article
  6. Access Site and Pacemaker Outcomes After TAVR in HFrEF Patients: Axillary vs Femoral Approach.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2025
    Article
  7. Article
  8. Review
  9. Article
  10. Percutaneous versus surgical transaxillary access for transcatheter aortic valve replacement: a propensity-matched analysis of the US experience.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022
    Article
  11. Observational
  12. Article
  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Yong ZhanDivision of Cardiac Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Siavash SaadatDivision of Cardiac Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Avneet SoinDivision of Cardiac Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Masashi KawaboriDivision of Cardiac Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Frederick Y ChenDivision of Cardiac Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Tufts Medical Center · USTufts University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile transfemoral (TF) approach is considered as the default access for transcatheter aortic valve replacement (TAVR), the alternative access route of choice remains to be elucidated. Transaxillary (TAx) approach has shown promise as an excellent option. We performed a meta-analysis of the studies comparing the TF and TAx approaches using one type of self-expandable transcatheter valve to avoid device-related bias.

methodsWe searched PubMed/MEDLINE, EMBASE, and the Cochrane Library from inception to December 2018 to identify articles comparing TAx-TAVR and TF-TAVR. The studies included in this meta-analysis contain data related to the use of the CoreValve device. Patients' baseline characteristics, procedural outcomes, and clinical outcomes were extracted from the articles and pooled for analysis.

resultsThe meta-analysis included five studies comprising 1,414 patients in the TF group and 489 patients in the TAx group. The average EuroScores of the TF and TAx groups were 20.04±13.89 and 22.73±14.73, respectively. The TAx group has higher rates of major comorbidities. No difference was found between the two groups with regard to vascular complications (P=0.71; OR 1.08; 95% CI, 0.71-1.65), aortic regurgitation (P=0.90; OR 1.03; 95% CI, 0.71-1.49), and permanent pacemaker (PPM) implantation (P=0.42; OR 1.12; 95% CI, 0.86-1.46). The TAx group has a lower incidence of acute kidney injury (AKI) (P=0.05; OR 1.63; 95% CI, 1.01-2.62). No difference was observed in 30-day mortality (P=0.32; OR 1.30; 95% CI, 0.78-2.17) or 1-year mortality (P=0.21; OR 0.76; 95% CI, 0.50-1.16).

conclusionsTAx-TAVR is associated with overall comparable outcomes to TF TAVR in high-risk patient cohorts, despite higher incidences of major comorbidities in the TAx-TAVR patient population. The rate of AKI appears to be lower after TAx-TAVR.

Indexed as

transaxillary (TAx)Transcatheter aortic valve replacement (TAVR)transfemoral (TF)

Identifiers

PMID32030231
PMCPMC6988006
OpenAlexW2997480903

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.