Evidence map›Paper›PMID 41196360›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2025

Intravascular lithotripsy enables safe and effective transfemoral aortic valve replacement.

Constantin von Zur Mühlen, Christian Valina, Laura Vagner, Lara Mack, Alexander Asmussen, Alexandra Lindau, Philipp Ruile, Manuel Hein, Martin Moser, Peter Stachon and 8 more

Abstract read
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

18 authors.

Constantin von Zur Mühlen *Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Christian Valina *Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Laura VagnerDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Lara MackDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Alexander AsmussenDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Alexandra LindauDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Philipp RuileDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Manuel HeinDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Martin MoserDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Peter StachonDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Klaus KaierFaculty of Medicine, Institute of Medical Biometry and Statistics, Medical Center, University of Freiburg, Freiburg, Germany.
Tau HartikainenDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Alexander MaierDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Markus JäckelDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Martin CzernyDepartment of Cardiovascular Surgery, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Freiburg, Germany.
Dirk WestermannDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Vera Oettinger *Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Jonathan Rilinger *Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. jonathan.rilinger@uniklinik-freiburg.de.ORCID http://orcid.org/0000-0001-9333-3629

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with severe peripheral artery disease (PAD), transfemoral transcatheter aortic valve replacement (TAVR) is often not feasible.

objectivesIliofemoral calcium modification by intravascular lithotripsy (IVL) may enable transfemoral access in PAD patients.

methodsBetween June 2022 and February 2024, all consecutive TAVR patients at our institution were prospectively screened for use of IVL according to the predefined TREATABLE classification, involving parameters such as calcification, vessel kinking and stenosis. Endpoints comprised successful TAVR, safety, and three-month outcomes (DRKS00034681). In an independent retrospective approach, all TAVR patients treated between February 2020 and June 2022 were evaluated with the TREATABLE classification towards complication rates without use of IVL (DRKS00029242).

resultsTwo hundred twenty-nine prospective patients were included and after application of the TREATABLE classification, 26 patients (11.4%) received IVL-supported transfemoral TAVR. According to the TREATABLE classification, there was a similar extent of kinking (p = 0.468), but a significantly higher severity of calcification in the IVL-treated group (p < 0.001). In the retrospective analysis of the additional 1000 patients, 966 (96.6%) received transfemoral and 34 alternative access TAVR. 154 transfemoral and all alternative access TAVR were identified as high-risk according to the TREATABLE classification. Comparing the retrospective and prospective TREATABEL cohorts, transfemoral high-risk patients in the retrospective cohort without IVL showed a higher rate of post-interventional stenosis or occlusion (12.3% vs. 0%, p = 0.049).

conclusionThis observational study shows a favourable success and safety level of IVL-supported transfemoral TAVR despite severe PAD, based on the TREATABLE classification. Therefore, the newly developed classification provides a suitable tool for identifying patients who would benefit from facilitating transfemoral TAVR by IVL.

Indexed as

Aortic valve stenosisLithotripsyPeripheral artery diseaseTAVRTransfemoral transcatheter aortic valve replacement

Identifiers

PMID41196360

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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.