The PIGTAIL paradigm for a fast and safe transfemoral transcatheter aortic valve replacement

Catheter Cardiovasc Interv. 2024 Sep;104(3):600-613. doi: 10.1002/ccd.31090. Epub 2024 May 21.

Abstract

Transfemoral transcatheter aortic valve replacement is the preferred primary access route whenever possible. Despite advancements in expertise and delivery system profiles, complications associated with the primary femoral access still significantly affect procedural morbidity and outcomes. The current standard for accurate main access planning involves proper preprocedural evaluation guided by computed tomography. Several baseline clinical and anatomical features serve as predictors for the risk of vascular injury occurring during or after transcatheter aortic valve replacement. In this paper, we aimed at reviewing the most up-to-date knowledge of the topic for a safe transfemoral access approach according to a paradigm we have called "PIGTAIL."

Keywords: aortic valve disease; percutaneous intervention; transcatheter valve implantation; vascular access complications.

Publication types

  • Review

MeSH terms

  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery
  • Aortic Valve* / diagnostic imaging
  • Aortic Valve* / physiopathology
  • Aortic Valve* / surgery
  • Catheterization, Peripheral* / adverse effects
  • Femoral Artery* / diagnostic imaging
  • Heart Valve Prosthesis
  • Humans
  • Prosthesis Design
  • Punctures*
  • Risk Assessment
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Transcatheter Aortic Valve Replacement* / instrumentation
  • Treatment Outcome
  • Vascular System Injuries / diagnostic imaging
  • Vascular System Injuries / etiology
  • Vascular System Injuries / prevention & control