Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study
Objectives: Patients undergoing trans-carotid transcatheter aortic valve replacement (TC-TAVR) are more likely to suffer from a stroke because of cerebral blood hypoperfusion and blood occlusion caused by the introducer sheath compared with the trans-femoral (TF) approach. The present study aimed to...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2021-01-01
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| Series: | Cardiology Plus |
| Subjects: | |
| Online Access: | http://www.cardiologyplus.org/article.asp?issn=2470-7511;year=2021;volume=6;issue=3;spage=181;epage=186;aulast=Yang |
| _version_ | 1798045201602707456 |
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| author | Li-Fan Yang Wen-Zhi Pan Li-Hua Guan Xiao-Chun Zhang Lei Zhang Sha-Sha Chen Da-Xin Zhou Jun-Bo Ge |
| author_facet | Li-Fan Yang Wen-Zhi Pan Li-Hua Guan Xiao-Chun Zhang Lei Zhang Sha-Sha Chen Da-Xin Zhou Jun-Bo Ge |
| author_sort | Li-Fan Yang |
| collection | DOAJ |
| description | Objectives: Patients undergoing trans-carotid transcatheter aortic valve replacement (TC-TAVR) are more likely to suffer from a stroke because of cerebral blood hypoperfusion and blood occlusion caused by the introducer sheath compared with the trans-femoral (TF) approach. The present study aimed to compare the incidence of stroke between the TC and TF approaches and explore the causes of stroke after TAVR. Methods: We retrospectively reviewed the medical records of 414 consecutive patients with severe aortic valve stenosis who underwent TC- or TF-TAVR at our center from October 2010 to November 2019; these patients were included in this observational study. The clinical data, such as the incidence of stroke, were compared between TC- and TF-TAVR patients. The correlation between carotid artery blood block interval (CABBI) and neurological events was also analyzed. The study was approved by the Ethics Committee of Zhongshan Hospital of Fudan University (approval No. YL2014-32). Results: Patients undergoing TC-TAVR had a significantly higher incidence of stroke than those undergoing TF-TAVR (12.5% vs. 0, P < 0.001), whereas the baseline data and the incidence of other complications did not differ significantly between the patients undergoing TC- and TF-TAVR (P > 0.05). Moreover, in TC-TAVR patients, the average CABBI of stroke was significantly longer than that of nonstroke patients (61.7 ± 20.7 min vs. 25.1 ± 1.6 min, P = 0.001). The number of patients with CABBI >30 min in the stroke group was greater than that in the nonstroke group (P < 0.001). Conclusions: In the absence of the cerebral and carotid artery evaluation before TAVR, surgeons should take into consideration the time of CABBI <30 min to avoid the possibility of stroke. |
| first_indexed | 2024-04-11T23:16:53Z |
| format | Article |
| id | doaj.art-a13f364952004a9490739078a87b5b11 |
| institution | Directory Open Access Journal |
| issn | 2470-7511 2470-752X |
| language | English |
| last_indexed | 2024-04-11T23:16:53Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Cardiology Plus |
| spelling | doaj.art-a13f364952004a9490739078a87b5b112022-12-22T03:57:36ZengWolters Kluwer Health/LWWCardiology Plus2470-75112470-752X2021-01-016318118610.4103/2470-7511.327241Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational studyLi-Fan YangWen-Zhi PanLi-Hua GuanXiao-Chun ZhangLei ZhangSha-Sha ChenDa-Xin ZhouJun-Bo GeObjectives: Patients undergoing trans-carotid transcatheter aortic valve replacement (TC-TAVR) are more likely to suffer from a stroke because of cerebral blood hypoperfusion and blood occlusion caused by the introducer sheath compared with the trans-femoral (TF) approach. The present study aimed to compare the incidence of stroke between the TC and TF approaches and explore the causes of stroke after TAVR. Methods: We retrospectively reviewed the medical records of 414 consecutive patients with severe aortic valve stenosis who underwent TC- or TF-TAVR at our center from October 2010 to November 2019; these patients were included in this observational study. The clinical data, such as the incidence of stroke, were compared between TC- and TF-TAVR patients. The correlation between carotid artery blood block interval (CABBI) and neurological events was also analyzed. The study was approved by the Ethics Committee of Zhongshan Hospital of Fudan University (approval No. YL2014-32). Results: Patients undergoing TC-TAVR had a significantly higher incidence of stroke than those undergoing TF-TAVR (12.5% vs. 0, P < 0.001), whereas the baseline data and the incidence of other complications did not differ significantly between the patients undergoing TC- and TF-TAVR (P > 0.05). Moreover, in TC-TAVR patients, the average CABBI of stroke was significantly longer than that of nonstroke patients (61.7 ± 20.7 min vs. 25.1 ± 1.6 min, P = 0.001). The number of patients with CABBI >30 min in the stroke group was greater than that in the nonstroke group (P < 0.001). Conclusions: In the absence of the cerebral and carotid artery evaluation before TAVR, surgeons should take into consideration the time of CABBI <30 min to avoid the possibility of stroke.http://www.cardiologyplus.org/article.asp?issn=2470-7511;year=2021;volume=6;issue=3;spage=181;epage=186;aulast=Yangcarotid artery blood block interval; stroke; trans-carotid approach; transcatheter aortic valve replacement; trans-femoral approach |
| spellingShingle | Li-Fan Yang Wen-Zhi Pan Li-Hua Guan Xiao-Chun Zhang Lei Zhang Sha-Sha Chen Da-Xin Zhou Jun-Bo Ge Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study Cardiology Plus carotid artery blood block interval; stroke; trans-carotid approach; transcatheter aortic valve replacement; trans-femoral approach |
| title | Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study |
| title_full | Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study |
| title_fullStr | Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study |
| title_full_unstemmed | Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study |
| title_short | Association between stroke and carotid artery blood block interval in trans-carotid transcatheter aortic valve replacement: A retrospective observational study |
| title_sort | association between stroke and carotid artery blood block interval in trans carotid transcatheter aortic valve replacement a retrospective observational study |
| topic | carotid artery blood block interval; stroke; trans-carotid approach; transcatheter aortic valve replacement; trans-femoral approach |
| url | http://www.cardiologyplus.org/article.asp?issn=2470-7511;year=2021;volume=6;issue=3;spage=181;epage=186;aulast=Yang |
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