Outcomes of Transcarotid Versus Trans-Subclavian Transcatheter Aortic Valve Replacement : A Systematic Review and Meta-Analysis
Copyright © 2021 Elsevier Inc. All rights reserved..
OBJECTIVES: This study aimed to perform the first meta-analysis of studies comparing transcarotid (TC) and trans-subclavian (TSc) transcatheter aortic valve replacement (TAVR).
BACKGROUND: The safety and feasibility of a TC and a TSc approach for performing TAVR in patients with prohibitive femoral anatomy have been well described. The potential advantage of one approach over the other is yet to be ascertained.
METHODS: A computerized literature search of key medical databases through September 2020 was performed. Randomized controlled trials (RCTs) and observational studies comparing TC and TSc TAVR with reported 30-day outcomes were considered. The primary endpoint was a composite of all-cause mortality, stroke, life-threatening, and/or major bleeding or major vascular complications. Statistical analysis using random-effects models to report the odds ratio (OR) with 95% confidence interval (CI) was performed.
RESULTS: A total of 5 observational studies inclusive of 4164 patients (TC = 1788 and TSc = 2376) met the eligibility criteria. The average age of patients was 81.1 years. There was no difference in the occurrence of the composite endpoint between the groups at 30-days. A statistically insignificant trend towards higher rates of major vascular complications (OR 1.65; 95% CI 0.94-2.89; P = 0.08; I2 = 0%) and the need for permanent pacemaker placement was observed with the TSc approach.
CONCLUSIONS: This meta-analysis of studies comparing TC and TSc TAVR showed similar 30-day outcomes between the 2 approaches. A notable trend towards higher rates of major vascular complications and the need for permanent pacemaker placement was observed with the TSc approach.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
|---|---|
| Enthalten in: |
Cardiovascular revascularization medicine : including molecular interventions - 33(2021) vom: 16. Dez., Seite 20-25 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Amer, Mostafa R [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Completed 31.12.2021 Date Revised 31.12.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.carrev.2021.01.001 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM320096734 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM320096734 | ||
| 003 | DE-627 | ||
| 005 | 20231225172839.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.carrev.2021.01.001 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1066.xml |
| 035 | |a (DE-627)NLM320096734 | ||
| 035 | |a (NLM)33446436 | ||
| 035 | |a (PII)S1553-8389(21)00004-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Amer, Mostafa R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of Transcarotid Versus Trans-Subclavian Transcatheter Aortic Valve Replacement |b A Systematic Review and Meta-Analysis |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 31.12.2021 | ||
| 500 | |a Date Revised 31.12.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: This study aimed to perform the first meta-analysis of studies comparing transcarotid (TC) and trans-subclavian (TSc) transcatheter aortic valve replacement (TAVR) | ||
| 520 | |a BACKGROUND: The safety and feasibility of a TC and a TSc approach for performing TAVR in patients with prohibitive femoral anatomy have been well described. The potential advantage of one approach over the other is yet to be ascertained | ||
| 520 | |a METHODS: A computerized literature search of key medical databases through September 2020 was performed. Randomized controlled trials (RCTs) and observational studies comparing TC and TSc TAVR with reported 30-day outcomes were considered. The primary endpoint was a composite of all-cause mortality, stroke, life-threatening, and/or major bleeding or major vascular complications. Statistical analysis using random-effects models to report the odds ratio (OR) with 95% confidence interval (CI) was performed | ||
| 520 | |a RESULTS: A total of 5 observational studies inclusive of 4164 patients (TC = 1788 and TSc = 2376) met the eligibility criteria. The average age of patients was 81.1 years. There was no difference in the occurrence of the composite endpoint between the groups at 30-days. A statistically insignificant trend towards higher rates of major vascular complications (OR 1.65; 95% CI 0.94-2.89; P = 0.08; I2 = 0%) and the need for permanent pacemaker placement was observed with the TSc approach | ||
| 520 | |a CONCLUSIONS: This meta-analysis of studies comparing TC and TSc TAVR showed similar 30-day outcomes between the 2 approaches. A notable trend towards higher rates of major vascular complications and the need for permanent pacemaker placement was observed with the TSc approach | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Subclavian | |
| 650 | 4 | |a TAVI | |
| 650 | 4 | |a TAVR | |
| 650 | 4 | |a Transcarotid | |
| 650 | 4 | |a Transcatheter aortic valve implantation | |
| 650 | 4 | |a Transcatheter aortic valve replacement | |
| 700 | 1 | |a Mosleh, Wassim |e verfasserin |4 aut | |
| 700 | 1 | |a Megaly, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Tanvi |e verfasserin |4 aut | |
| 700 | 1 | |a Ooi, Yinn Shaung |e verfasserin |4 aut | |
| 700 | 1 | |a McKay, Raymond G |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cardiovascular revascularization medicine : including molecular interventions |d 2005 |g 33(2021) vom: 16. Dez., Seite 20-25 |w (DE-627)NLM158711297 |x 1878-0938 |7 nnns |
| 773 | 1 | 8 | |g volume:33 |g year:2021 |g day:16 |g month:12 |g pages:20-25 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.carrev.2021.01.001 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 33 |j 2021 |b 16 |c 12 |h 20-25 | ||