ArticleJACC. Cardiovascular interventions2022
Transcaval Versus Transaxillary TAVR in Contemporary Practice: A Propensity-Weighted Analysis.
Article in JACC. Cardiovascular interventions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed, 52 citations in OpenAlex.
- Percutaneous Transaxillary Access for Large-Bore Cardiovascular Interventions: Evidence, Technique, and Complication Management.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Review
- Enabling Transfemoral TAVI Through a Hostile Abdominal Aortic Anatomy and a Migrated Mesenteric Stent Fragment: Review of the Literature and a Case Presentation.Life (Basel, Switzerland) · 2026Review
- Stroke Rates and Clinical Outcomes After Transcaval Transcatheter Aortic Valve Replacement With and Without Central Embolic Protection: A Single-Center Experience.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Managing Complex Anatomical Scenarios in Tavi: Evidence and an Institutional Perspective.Journal of clinical medicine · 2025Review
- The Emerging Role of Lithotripsy in Structural Heart Interventions.Current cardiology reports · 2025Review
- Transcaval Transcatheter Aortic Valve Replacement: Clinical Outcomes From a TAVI Program Without Prior Transcaval Experience.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Article
- Comparison of Valve Academic Research Consortium (VARC)-2 and VARC-3 Criteria for Bleeding Complications After Transcatheter Aortic Valve Replacement.Journal of the American Heart Association · 2025Article
- Complex Transfemoral Access During Transcatheter Aortic Valve Replacement: A Narrative Review of Management, Complexity Scores, and Alternative Access.Life (Basel, Switzerland) · 2025Review
- Transcaval access for transcatheter aortic valve replacement: a systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2025Article
- Incidence, Risk Factors, and Stroke Prevention During Transcatheter Aortic Valve Implantation.Reviews in cardiovascular medicine · 2025Review
- [Advances in stroke after transcatheter aortic valve replacement].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2025Review
- A comparative study on iliofemoral artery calcification distribution in alternative TAVR approaches.Indian journal of thoracic and cardiovascular surgery · 2025Article
- SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Access Options for Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2025Review
- Right transaxillary transcatheter aortic valve replacement is comparable to left despite challenges.General thoracic and cardiovascular surgery · 2024Article
- An Updated Comprehensive Review of Existing Transcatheter Aortic Valve Replacement Access.Journal of cardiovascular translational research · 2024Review
- Cerebrovascular events after transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Review
- Transcaval Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation Using a Dedicated Self-Expanding Device.JACC. Case reports · 2024Article
- Trends in transcatheter aortic valve implantation practice and clinical outcomes at an Irish tertiary referral centre.Open heart · 2024Article
- Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic Valve Replacement: A Systematic Review with Meta-Analysis.Journal of clinical medicine · 2024Review
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Authors and funding
16 authors at 11 institutions in 1 country.
Funding
Abstract
objectivesThe aim of this study was to compare transcaval and transaxillary artery access for transcatheter aortic valve replacement (TAVR) at experienced medical centers in contemporary practice.
backgroundThere are no systematic comparisons of transcaval and transaxillary TAVR access routes.
methodsEight experienced centers contributed local data collected for the STS/ACC TVT Registry (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry) between 2017 and 2020. Outcomes after transcaval and axillary/subclavian (transaxillary) access were adjusted for baseline imbalances using doubly robust (inverse propensity weighting plus regression) estimation and compared.
resultsTranscaval access was used in 238 procedures and transaxillary access in 106; for comparison, transfemoral access was used in 7,132 procedures. Risk profiles were higher among patients selected for nonfemoral access but similar among patients requiring transcaval and transaxillary access. Stroke and transient ischemic attack were 5-fold less common after transcaval than transaxillary access (2.5% vs 13.2%; OR: 0.20; 95% CI: 0.06-0.72; P = 0.014) compared with transfemoral access (1.7%). Major and life-threatening bleeding (Valve Academic Research Consortium 3 ≥ type 2) were comparable (10.0% vs 13.2%; OR: 0.66; 95% CI: 0.26-1.66; P = 0.38) compared with transfemoral access (3.5%), as was blood transfusion (19.3% vs 21.7%; OR: 1.07; 95% CI: 0.49-2.33; P = 0.87) compared with transfemoral access (7.1%). Vascular complications, intensive care unit and hospital length of stay, and survival were similar between transcaval and transaxillary access. More patients were discharged directly home and without stroke or transient ischemic attack after transcaval than transaxillary access (87.8% vs 62.3%; OR: 5.19; 95% CI: 2.45-11.0; P < 0.001) compared with transfemoral access (90.3%).
conclusionsPatients undergoing transcaval TAVR had lower rates of stroke and similar bleeding compared with transaxillary access in a contemporary experience from 8 US centers. Both approaches had more complications than transfemoral access. Transcaval TAVR access may offer an attractive option.
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