Original Research

DOI: 10.4244/EIJ-D-23-00725

A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study

Liesbeth Rosseel1,2, MD; Nicholas J. Montarello1, MD; Philippe Nuyens1, MD; Gabriella Tirado-Conte1, MD; Angelo Quagliana1, MD; Kristoff Cornelis3, MD; Vincent Floré3, MD, PhD; Michael Rosseel2, MD; Gintautas Bieliauskas1, MD; Lars Sondergaard4, MD, DMSc; Ole De Backer1, MD, PhD

Abstract

Background: Despite transcatheter aortic valve implantation (TAVI) having become a routine procedure, access site bleeding and vascular complications are still a concern which contribute to procedure-related morbidity and mortality.

Aims: The TAVI-MultiCLOSE study aimed to assess the safety and efficacy of a new vascular closure algorithm for percutaneous large-bore arterial access closure following transfemoral (TF)-TAVI.

Methods: All consecutive TF-TAVI cases in which the MultiCLOSE vascular closure algorithm was used were prospectively included in a multicentre, observational study. This stepwise algorithm entails the reinsertion of a 6-8 Fr sheath (primary access) following the initial preclosure with one or two suture-based vascular closure devices (VCDs). This provides the operator with the opportunity to perform a quick and easy angiographic control and tailor the final vascular closure with either an additional suture- or plug-based VCD, or neither of these.

Results: Among 630 patients who underwent TF-TAVI utilising the MultiCLOSE algorithm, complete arterial haemostasis was achieved in 616 patients (98%). VCD failure occurred in 14 patients (2%), treated with either balloon inflation (N=1), covered stent (N=12) or surgical repair (N=1). Overall, this vascular...

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Volume 20 Number 6
Mar 18, 2024
Volume 20 Number 6
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