Oral Presentation No. 089 Vascular access computed tomography angiography-derived iliofemoral calcium volume in the evaluation of vascular and bleeding complications after transfemoral TAVI

Abstract Background We aimed to assess the impact of iliofemoral calcium volume and distribution, as evaluated by computed tomography angiography (CTA), in vascular (VC) and bleeding (BC) complications after transfemoral (TF) TAVI. Material and methods Patients (pts) who underwent TF TAVI in 2017 (fluoroscopy-guided access) and between 2018 and 2019 (echo-guided access) were included. All pts underwent iliofemoral CTA prior to the procedure and classical CTA-derived data and iliofemoral calcium volume ipsilateral to the puncture site were collected to evaluate its impact on VC and BC, which were defined by VARC-2 criteria. Results and conclusions We included 221 pts. VC occurred in 22,2% pts (18,6% minor, 3,6% major) and BC in 16,3% pts (13,6% minor, 2,2% major, 0,5% life-threatening). There was a significant lower prevalence of VC (16,4% vs. 28,6%, P = 0,029) and BC (8,6% vs. 24,8%, P = 0,001) in the echo-guided group. Univariate analysis showed that external iliac artery (EIA) and common femoral artery (CFA) luminal minimal diameter and area, CFA maximal luminal diameter were significantly smaller in pts with VC and BC. Sheath to external iliac artery ratio (SEIAR) and sheath to femoral artery ratio (SFAR) were higher in pts with VC and BC. There were no significant differences in CTA-derived total Iliofemoral calcium volume, EIA and CFA calcium volume between pts with or without VC and BC. In conclusion, iliofemoral calcium volume was not associated with VC and BC after TAVI, while other classical CTA-derived factors such as SEIAR, SFAR, EIA and CFA minimal diameter and area were.