Intravascular lithotripsy to facilitate transfemoral TAVI: a single-center experience

Abstract Introduction Transfemoral is considered the approach of choice for transcatheter aortic valve implantation (TAVI) and improves clinical outcomes such as death or stroke compared to transaortic transapical access. Intravascular lithotripsy (IVL) has enabled modification calcified intimal medial lesions increase vascular wall compliance which might facilitate transfemoral TAVI approach. Purpose To present a single-center experience with intravascular facilitating Methods A peripheral IVL catheter was used perform iliofemoral stenosis. 0.014" guidewire guide balloon diameter 5.0 6.0 mm. Inflating 4–6 atm pressure apposition arterial several cycles 30 pulses have been performed at various locations arteries. planned in advance primary strategy case ring baillout excentric periferial artery stenosis, respectively. The immediately followed by TAVI. Retrograde data were collected purpose this abstract. Results From December 2019 2021 433 procedures University Medical Centre Ljubljana. In 13 (3%) mean minimal arteries 5,2 mm calcifications affecting least three-quarters circumference 92% circular 62% cases. all cases, common iliac bifurcation, while external (15%) femoral (8%) treated less often. 5 2 (15%), 6 9 (69%) combination balloons subsequent successful No hospital mortality major bleeding observed. One patient needed one unit blood transfusion due loss during surgical preparation closure puncture site. site closed using Proglide technique no conversion from percutaneous needed. self-expanding prosthesis (Evolut R, Medtronic) 11 (85%) balloon-expandable (Sapien 3, Edwards Lifesciences) Conclusion our safe effective method TAVI, especially cases majority circumference. Funding Acknowledgement Type funding sources: None.