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Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation

Elliott J Carande, Tarik S Salim, Alexander Chase, Baskar Sekar, Omar Aldalati, Ahmed Hailan, Ayush Khurana, Dave Smith, Daniel Obaid Orcid Logo

The British Journal of Radiology, Volume: 96, Issue: 1152

Swansea University Author: Daniel Obaid Orcid Logo

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DOI (Published version): 10.1259/bjr.20230296

Abstract

Objective:Vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) are common and lead to increased morbidity and mortality. Analysis of plaque at the arterial access site may improve prediction of complications.Methods:We investigated the association between demograp...

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Published in: The British Journal of Radiology
ISSN: 0007-1285 1748-880X
Published: Oxford University Press (OUP) 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa65387
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Analysis of plaque at the arterial access site may improve prediction of complications.Methods:We investigated the association between demographic and procedural risk factors for Valve Academic Research Consortium (VARC-3) vascular complications in patients undergoing transfemoral TAVI with use of a vascular closure device (ProGlide® or MANTA®) in this retrospective cohort study. The ability of pre-procedure femoral CT angiography to predict complications was investigated including a novel method of quantifying plaque composition of the common femoral artery using plaque maps created with patient specific X-ray attenuation cut-offs.Results:23 vascular complications occurred in the 299 patients in the study group (7.7%). There were no demographic risk factors associated with vascular complications and no statistical difference between use of closure device (ProGlide®vs MANTA®) and vascular complications. Vascular complications after TAVI were associated with sheath size (OR 1.36, 95% CI 1.08–1.76, P 0.01) and strongly associated with CT-derived necrotic core volume in the common femoral artery of the procedural side (OR 17.49, 95% CI 1.21–226.60, P 0.03).Conclusion:Plaque map analysis of the common femoral artery by CT angiography reveals patients with greater necrotic core are at increased risk of VARC-3 vascular complications.Advances in knowledge:The novel measurement of necrotic core volume in the common femoral artery on the procedural side by CT analysis was associated with post-TAVI vascular complications, which can be used to highlight increased risk.</abstract><type>Journal Article</type><journal>The British Journal of Radiology</journal><volume>96</volume><journalNumber>1152</journalNumber><paginationStart/><paginationEnd/><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0007-1285</issnPrint><issnElectronic>1748-880X</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-12-01</publishedDate><doi>10.1259/bjr.20230296</doi><url/><notes/><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders/><projectreference/><lastEdited>2024-03-13T18:00:44.1852668</lastEdited><Created>2023-12-30T14:22:05.8485746</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Biomedical Science</level></path><authors><author><firstname>Elliott J</firstname><surname>Carande</surname><order>1</order></author><author><firstname>Tarik S</firstname><surname>Salim</surname><order>2</order></author><author><firstname>Alexander</firstname><surname>Chase</surname><order>3</order></author><author><firstname>Baskar</firstname><surname>Sekar</surname><order>4</order></author><author><firstname>Omar</firstname><surname>Aldalati</surname><order>5</order></author><author><firstname>Ahmed</firstname><surname>Hailan</surname><order>6</order></author><author><firstname>Ayush</firstname><surname>Khurana</surname><order>7</order></author><author><firstname>Dave</firstname><surname>Smith</surname><order>8</order></author><author><firstname>Daniel</firstname><surname>Obaid</surname><orcid>0000-0002-3891-1403</orcid><order>9</order></author></authors><documents><document><filename>65387__29391__c188e5531849445da8747512cf597ef8.pdf</filename><originalFilename>65387.pdf</originalFilename><uploaded>2024-01-05T12:33:40.4928185</uploaded><type>Output</type><contentLength>543158</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2023 The Authors. 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spelling v2 65387 2023-12-30 Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation 1cb4b49224d4f3f2b546ed0f39e13ea8 0000-0002-3891-1403 Daniel Obaid Daniel Obaid true false 2023-12-30 BMS Objective:Vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) are common and lead to increased morbidity and mortality. Analysis of plaque at the arterial access site may improve prediction of complications.Methods:We investigated the association between demographic and procedural risk factors for Valve Academic Research Consortium (VARC-3) vascular complications in patients undergoing transfemoral TAVI with use of a vascular closure device (ProGlide® or MANTA®) in this retrospective cohort study. The ability of pre-procedure femoral CT angiography to predict complications was investigated including a novel method of quantifying plaque composition of the common femoral artery using plaque maps created with patient specific X-ray attenuation cut-offs.Results:23 vascular complications occurred in the 299 patients in the study group (7.7%). There were no demographic risk factors associated with vascular complications and no statistical difference between use of closure device (ProGlide®vs MANTA®) and vascular complications. Vascular complications after TAVI were associated with sheath size (OR 1.36, 95% CI 1.08–1.76, P 0.01) and strongly associated with CT-derived necrotic core volume in the common femoral artery of the procedural side (OR 17.49, 95% CI 1.21–226.60, P 0.03).Conclusion:Plaque map analysis of the common femoral artery by CT angiography reveals patients with greater necrotic core are at increased risk of VARC-3 vascular complications.Advances in knowledge:The novel measurement of necrotic core volume in the common femoral artery on the procedural side by CT analysis was associated with post-TAVI vascular complications, which can be used to highlight increased risk. Journal Article The British Journal of Radiology 96 1152 Oxford University Press (OUP) 0007-1285 1748-880X 1 12 2023 2023-12-01 10.1259/bjr.20230296 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University SU Library paid the OA fee (TA Institutional Deal) 2024-03-13T18:00:44.1852668 2023-12-30T14:22:05.8485746 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Elliott J Carande 1 Tarik S Salim 2 Alexander Chase 3 Baskar Sekar 4 Omar Aldalati 5 Ahmed Hailan 6 Ayush Khurana 7 Dave Smith 8 Daniel Obaid 0000-0002-3891-1403 9 65387__29391__c188e5531849445da8747512cf597ef8.pdf 65387.pdf 2024-01-05T12:33:40.4928185 Output 543158 application/pdf Version of Record true © 2023 The Authors. Published by the British Institute of Radiology under the terms of the Creative Commons Attribution 4.0 Unported License true eng https://creativecommons.org/licenses/by/4.0/
title Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
spellingShingle Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
Daniel Obaid
title_short Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
title_full Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
title_fullStr Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
title_full_unstemmed Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
title_sort Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation
author_id_str_mv 1cb4b49224d4f3f2b546ed0f39e13ea8
author_id_fullname_str_mv 1cb4b49224d4f3f2b546ed0f39e13ea8_***_Daniel Obaid
author Daniel Obaid
author2 Elliott J Carande
Tarik S Salim
Alexander Chase
Baskar Sekar
Omar Aldalati
Ahmed Hailan
Ayush Khurana
Dave Smith
Daniel Obaid
format Journal article
container_title The British Journal of Radiology
container_volume 96
container_issue 1152
publishDate 2023
institution Swansea University
issn 0007-1285
1748-880X
doi_str_mv 10.1259/bjr.20230296
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
active_str 0
description Objective:Vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) are common and lead to increased morbidity and mortality. Analysis of plaque at the arterial access site may improve prediction of complications.Methods:We investigated the association between demographic and procedural risk factors for Valve Academic Research Consortium (VARC-3) vascular complications in patients undergoing transfemoral TAVI with use of a vascular closure device (ProGlide® or MANTA®) in this retrospective cohort study. The ability of pre-procedure femoral CT angiography to predict complications was investigated including a novel method of quantifying plaque composition of the common femoral artery using plaque maps created with patient specific X-ray attenuation cut-offs.Results:23 vascular complications occurred in the 299 patients in the study group (7.7%). There were no demographic risk factors associated with vascular complications and no statistical difference between use of closure device (ProGlide®vs MANTA®) and vascular complications. Vascular complications after TAVI were associated with sheath size (OR 1.36, 95% CI 1.08–1.76, P 0.01) and strongly associated with CT-derived necrotic core volume in the common femoral artery of the procedural side (OR 17.49, 95% CI 1.21–226.60, P 0.03).Conclusion:Plaque map analysis of the common femoral artery by CT angiography reveals patients with greater necrotic core are at increased risk of VARC-3 vascular complications.Advances in knowledge:The novel measurement of necrotic core volume in the common femoral artery on the procedural side by CT analysis was associated with post-TAVI vascular complications, which can be used to highlight increased risk.
published_date 2023-12-01T18:00:39Z
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