TY - JOUR JO - EuroIntervention TI - Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study AB - <p><strong>Background:</strong> The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve implantation (TAVI) by the transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium and increases vessel compliance allowing TF TAVI in selected patients with peripheral artery disease (PAD).</p> <p><strong>Aims:</strong> The aim of this study was to report on the safety and efficacy of IVL-assisted TF TAVI in an all-comers population.</p> <p><strong>Methods:</strong> Clinical, imaging and procedural data on all consecutive patients treated by IVL-assisted TF TAVI in six high-volume European centres (2018-2020) were collected in this prospective, real-world, multicentre registry.</p> <p><strong>Results:</strong> IVL-assisted TF TAVI was performed in 108 patients, increasing from 2.4% to 6.5% of all TAVI from 2018 to 2020, respectively. The target lesion was most often localised at the common and/or external iliac artery (93.5% of cases; average TL-MLD 4.6&plusmn;0.9 mm with 318 degrees of calcium arc). Transfemoral aortic valve delivery was successful in 100% of cases; final procedural success in 98.2% (two conversions to cardiac open surgery for annular rupture and valve migration). Complications of the IVL-treated segments consisted of 1 perforation and 3 major dissections requiring stent implantation (2 covered stents and 2 BMS). Access-site-related complications included 3 major bleedings. Three in-hospital deaths were recorded (2.8%, 1 failed surgical conversion after annular rupture, 1 cardiac arrest after initial valvuloplasty, 1 late hyperkalaemia in renal dysfunction).</p> <p><strong>Conclusions:</strong> IVL-assisted TF TAVI proved to be a safe and effective approach, which helps to expand the indications for TF TAVI in patients with severe calcific PAD. However, these patients continue to have a higher-than-average incidence of periprocedural complications.</p> AU - Nardi Giulia AU - De Backer Ole AU - Saia Francesco AU - Søndergaard Lars AU - Ristalli Francesca AU - Meucci Francesco AU - Stolcova Miroslava AU - Mattesini Alessio AU - Demola Pierluigi AU - Wang Xi AU - Al Jabri Anees AU - Palmerini Tullio AU - Bruno Giulio Antonio AU - Ielasi Alfonso AU - Van Belle Eric AU - Berti Sergio AU - Di Mario Carlo VL - 17 IS - 17 Y1 - 01/04/2022 Y1 - 2022 DOI - 10.4244/EIJ-D-21-00581 SP - e1397 EP - e1406 KW - aortic stenosis KW - femoral KW - tavi PB - Europa Digital & Publishing SE - Interventions for valvular disease and heart failure UR - https://eurointervention.pcronline.com/article/peripheral-intravascular-lithotripsy-of-iliofemoral-arteries-to-facilitate-transfemoral-tavi-a-multicentre-prospective-registry SN - 1774-024X ER -