髂股动脉粥样硬化的严重程度和范围对接受 TAVR 患者临床结果的影响

IF 11.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI:10.1016/j.jcin.2024.07.009
{"title":"髂股动脉粥样硬化的严重程度和范围对接受 TAVR 患者临床结果的影响","authors":"","doi":"10.1016/j.jcin.2024.07.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Vascular complications remain a major concern in transfemoral transcatheter aortic valve replacement (TAVR). The Hostile score has been proposed to stratify risk in TAVR patients with peripheral artery disease.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess the validity of the Hostile score in predicting iliofemoral vascular complications after TAVR.</div></div><div><h3>Methods</h3><div>In a prospective TAVR registry, we validated the Hostile score for the prediction of puncture and non–puncture site vascular complications. This scoring system integrates the extent (number of lesions, lesion length, and minimum lumen diameter) and complexity (tortuosity, calcification, and the presence of obstruction) of iliofemoral atherosclerosis.</div></div><div><h3>Results</h3><div>Of 2,023 patients who underwent transfemoral TAVR with contemporary devices between March 2014 and June 2022, 106 (5.2%) patients experienced puncture site vascular complications and 28 (1.4%) patients experienced non–puncture site vascular complications. The Hostile score was higher in patients with vascular complications than those without complications (1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; <em>P</em> &lt; .001). A higher body mass index (OR: 1.23; 95% CI: 1.04-1.50) and the use of Prostar (OR: 6.03; 95% CI: 2.23-16.30) or MANTA (OR: 6.18; 95% CI: 2.67-14.27) compared with ProGlide were independent predictors of puncture site vascular complications, whereas a higher Hostile score (OR: 1.91; 95% CI: 1.55-2.35) and female sex (OR: 2.69; 95% CI: 1.12-6.42) were independent predictors of non–puncture site vascular complications. The area under the receiver-operating characteristic curves for the prediction of puncture site and non–puncture site vascular complications were 0.554 and 0.829, respectively.</div></div><div><h3>Conclusions</h3><div>The Hostile score proved useful in predicting non–puncture site vascular complications after TAVR. (SwissTAVI Registry; <span><span>NCT01368250</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR\",\"authors\":\"\",\"doi\":\"10.1016/j.jcin.2024.07.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Vascular complications remain a major concern in transfemoral transcatheter aortic valve replacement (TAVR). The Hostile score has been proposed to stratify risk in TAVR patients with peripheral artery disease.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess the validity of the Hostile score in predicting iliofemoral vascular complications after TAVR.</div></div><div><h3>Methods</h3><div>In a prospective TAVR registry, we validated the Hostile score for the prediction of puncture and non–puncture site vascular complications. This scoring system integrates the extent (number of lesions, lesion length, and minimum lumen diameter) and complexity (tortuosity, calcification, and the presence of obstruction) of iliofemoral atherosclerosis.</div></div><div><h3>Results</h3><div>Of 2,023 patients who underwent transfemoral TAVR with contemporary devices between March 2014 and June 2022, 106 (5.2%) patients experienced puncture site vascular complications and 28 (1.4%) patients experienced non–puncture site vascular complications. The Hostile score was higher in patients with vascular complications than those without complications (1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; <em>P</em> &lt; .001). A higher body mass index (OR: 1.23; 95% CI: 1.04-1.50) and the use of Prostar (OR: 6.03; 95% CI: 2.23-16.30) or MANTA (OR: 6.18; 95% CI: 2.67-14.27) compared with ProGlide were independent predictors of puncture site vascular complications, whereas a higher Hostile score (OR: 1.91; 95% CI: 1.55-2.35) and female sex (OR: 2.69; 95% CI: 1.12-6.42) were independent predictors of non–puncture site vascular complications. The area under the receiver-operating characteristic curves for the prediction of puncture site and non–puncture site vascular complications were 0.554 and 0.829, respectively.</div></div><div><h3>Conclusions</h3><div>The Hostile score proved useful in predicting non–puncture site vascular complications after TAVR. (SwissTAVI Registry; <span><span>NCT01368250</span><svg><path></path></svg></span>).</div></div>\",\"PeriodicalId\":14688,\"journal\":{\"name\":\"JACC. Cardiovascular interventions\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":11.7000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Cardiovascular interventions\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1936879824009646\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Cardiovascular interventions","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936879824009646","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景:血管并发症仍是经口经导管主动脉瓣置换术(TAVR)的主要问题。Hostile评分已被提出用于对患有外周动脉疾病的TAVR患者进行风险分层:作者旨在评估 Hostile 评分在预测 TAVR 术后髂股血管并发症方面的有效性:在一项前瞻性 TAVR 登记中,我们验证了 Hostile 评分预测穿刺和非穿刺部位血管并发症的有效性。该评分系统综合了髂股动脉粥样硬化的程度(病变数量、病变长度和最小管腔直径)和复杂性(迂曲、钙化和是否存在阻塞):2014年3月至2022年6月期间,2023名患者使用当代设备接受了经股动脉TAVR,其中106名(5.2%)患者出现了穿刺部位血管并发症,28名(1.4%)患者出现了非穿刺部位血管并发症。血管并发症患者的 "敌对 "评分高于无并发症患者(1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; P < .001)。与 ProGlide 相比,体重指数越高(OR:1.23;95% CI:1.04-1.50),使用 Prostar(OR:6.03;95% CI:2.23-16.30)或 MANTA(OR:6.18;95% CI:2.67-14.与 ProGlide 相比,Prostar(OR:6.03;95% CI:2.23-16.30)或 MANTA(OR:6.18;95% CI:2.67-14.27)是穿刺部位血管并发症的独立预测因素,而较高的 Hostile 评分(OR:1.91;95% CI:1.55-2.35)和女性性别(OR:2.69;95% CI:1.12-6.42)是非穿刺部位血管并发症的独立预测因素。预测穿刺部位和非穿刺部位血管并发症的接受者操作特征曲线下面积分别为 0.554 和 0.829:结论:Hostile评分有助于预测TAVR术后非穿刺部位血管并发症。(瑞士TAVI注册;NCT01368250)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR

Background

Vascular complications remain a major concern in transfemoral transcatheter aortic valve replacement (TAVR). The Hostile score has been proposed to stratify risk in TAVR patients with peripheral artery disease.

Objectives

The authors aimed to assess the validity of the Hostile score in predicting iliofemoral vascular complications after TAVR.

Methods

In a prospective TAVR registry, we validated the Hostile score for the prediction of puncture and non–puncture site vascular complications. This scoring system integrates the extent (number of lesions, lesion length, and minimum lumen diameter) and complexity (tortuosity, calcification, and the presence of obstruction) of iliofemoral atherosclerosis.

Results

Of 2,023 patients who underwent transfemoral TAVR with contemporary devices between March 2014 and June 2022, 106 (5.2%) patients experienced puncture site vascular complications and 28 (1.4%) patients experienced non–puncture site vascular complications. The Hostile score was higher in patients with vascular complications than those without complications (1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; P < .001). A higher body mass index (OR: 1.23; 95% CI: 1.04-1.50) and the use of Prostar (OR: 6.03; 95% CI: 2.23-16.30) or MANTA (OR: 6.18; 95% CI: 2.67-14.27) compared with ProGlide were independent predictors of puncture site vascular complications, whereas a higher Hostile score (OR: 1.91; 95% CI: 1.55-2.35) and female sex (OR: 2.69; 95% CI: 1.12-6.42) were independent predictors of non–puncture site vascular complications. The area under the receiver-operating characteristic curves for the prediction of puncture site and non–puncture site vascular complications were 0.554 and 0.829, respectively.

Conclusions

The Hostile score proved useful in predicting non–puncture site vascular complications after TAVR. (SwissTAVI Registry; NCT01368250).
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
JACC. Cardiovascular interventions
JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
8.80%
发文量
756
审稿时长
4-8 weeks
期刊介绍: JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.
期刊最新文献
Editorial Board A Novel Technique for the Common Femoral Artery and its Bifurcation Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR The Hostile Score Antithrombotic Therapy in High Bleeding Risk, Part II
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1