The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

Do we need alternative access in TAVR anymore?

EuroIntervention 2020;15:e1305-e1306. DOI: 10.4244/EIJV15I15A237

1. Department of Cardiology and Cardiovascular Surgery, Heart Valve Center, Institut Cœur Poumon CHU de Lille, Lille, France; 2. Department of Cardiac Surgery, Montreal Heart Institute, Montreal, QC, Canada


Transcatheter aortic valve replacement (TAVR) has expanded widely in recent years. The femoral access constitutes the gold standard and the first-line access for TAVR procedures1,2, allowing totally percutaneous procedures. Despite several iterations in device profiles and the improvement of TAVR techniques, 10 to 15% of patients are deemed ineligible for femoral access due to unfavourable femoral or aortic anatomy3. While the European guidelines4 recommend the surgical option in intermediate-risk patients if the femoral access is not feasible, non-femoral peripheral (nFP) accesses have emerged as alternatives to the femoral access, achieving comparable results in high-volume centres5,6 with a trend towards more minimalist ...

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