Imperial College London
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Professor Thanos Athanasiou MD PhD MBA FECTS FRCS

Faculty of Medicine, Department of Surgery & Cancer

Professor of Cardiovascular Sciences
 
 
 
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Contact

 

t.athanasiou

 
 
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Location

 

1022Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Al-Balah:2020:10.1016/j.ijcha.2020.100668,
author = {Al-Balah, A and Naqvi, D and Houbby, N and Chien, L and Sen, S and Athanasiou, T and Salmasi, MY},
doi = {10.1016/j.ijcha.2020.100668},
journal = {International Journal of Cardiology: Heart and Vasculature},
title = {Comparison of outcomes following transfemoral versus trans-subclavian approach for transcatheter aortic valve Implantation: a meta-analysis},
url = {http://dx.doi.org/10.1016/j.ijcha.2020.100668},
volume = {31},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe subclavian artery is an alternative access route for transcatheter aortic valve implantation (TAVI), with a potential advantage in patients unsuitable for traditional access routes such as the femoral artery. This study aimed to determine the safety and efficacy of the trans-subclavian (TSc) compared to the trans-femoral (TF) approach.MethodsA systematic review was conducted on two online databases: Embase and Medline. The initial search returned 508 titles. Nine observational studies were included: n = 2938 patients (2382 TF and 556 TSc).ResultsBoth TSc and TF groups were comparable for: 30-day mortality (Odds ratio, OR 0.75, 95% CI 0.49 – 1.16, p = 0.195); in-hospital stroke (OR 1.05, 95% CI 0.60–1.85, p = 0.859); myocardial infarction (OR 1.97, 95% CI 0.74–5.23, p = 0.176); paravalvular leaks (OR 1.20, 95% CI 0.76–1.90, p = 0.439); rates of postoperative permanent pacemaker implantation (OR 1.49, 95% CI 0.92–2.41, p = 0.105); in-hospital bleeding and meta-analysis demonstrated no significant difference between access points (OR 3.44, 95% CI 0.35–34.22, p = 0.292). Procedural time was found to be longer in the TSc group (SMD 1.02; 95% CI 0.815–1.219, p < 0.001). Major vascular complications were significantly higher in the TF group (OR 0.55, 95% CI 0.32–0.94, p = 0.029). Meta regression found no influence of the covariates on the outcomes.ConclusionSubclavian access is both a safe and feasible alternative access route for TAVI with lower risks of major vascular complications. This study supports the use of subclavian access as a viable alternative in patient groups where transfemoral TAVI is contraindicated.
AU  - Al-Balah,A
AU  - Naqvi,D
AU  - Houbby,N
AU  - Chien,L
AU  - Sen,S
AU  - Athanasiou,T
AU  - Salmasi,MY
DO  - 10.1016/j.ijcha.2020.100668
PY  - 2020///
SN  - 2352-9067
TI  - Comparison of outcomes following transfemoral versus trans-subclavian approach for transcatheter aortic valve Implantation: a meta-analysis
T2  - International Journal of Cardiology: Heart and Vasculature
UR  - http://dx.doi.org/10.1016/j.ijcha.2020.100668
UR  - http://hdl.handle.net/10044/1/84895
VL  - 31
ER  -
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