title: Inferior epigastric artery as a landmark for transfemoral TAVI. Optimizing vascular access?
abstract: OBJECTIVE
  This study sought to investigate whether the site of common femoral artery (CFA) cannulation in regard to the inferior epigastric artery (IEA) is associated with the incidence of vascular complications in patients undergoing transfemoral aortic valve implantation (TAVI).
  
  
  BACKGROUND
  Vascular access complications are a main issue during TAVI and have been associated with significant increase of morbidity and mortality. The need for establishment of reliable predictors for these serious events remains important.
  
  
  METHODS
  A total of 90 patients, who had undergone TAVI, were retrospectively studied. Vascular complications were defined as major and minor according to the Valve Academic Research Consortium (VARC) criteria. Patients were divided into high cannulation site (CS) group and low CS group depending on the common femoral artery puncture site position, in regards to the most inferior border of the IEA.
  
  
  RESULTS
  Vascular complications were significantly more frequent in the high CS group versus the low CS group (32.3% vs. 11.9%, P = 0.039). High cannulation remained an independent predictor of vascular complications after adjustment for known risk factors (OR: 4.827, CI: 1.441-16.168; P = 0.011).
  
  
  CONCLUSIONS
  In patients undergoing transfemoral TAVI, arterial puncture above the most inferior border of the IEA is associated with vascular complications.
authors.affiliation: Department of Cardiology, Hippokration Hospital, Medical School, National & Kapodistrian University of Athens, Greece.
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalogeras
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vrachatis
authors.forename: Maria
authors.initials: M
authors.lastname: Kariori
authors.forename: Vasilios
authors.initials: V
authors.lastname: Voudris
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Aznaouridis
authors.forename: Carmen
authors.initials: C
authors.lastname: Moldovan
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Georgios
authors.initials: G
authors.lastname: Lazaros
authors.forename: Konstantina
authors.initials: K
authors.lastname: Masoura
authors.forename: Sophia
authors.initials: S
authors.lastname: Thomopoulou
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D016009:Chi-Square Distribution; D019074:Epigastric Arteries / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011677:Punctures; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology