Prevalence of significant peripheral artery disease in patients evaluated for percutaneous aortic valve insertion: Preprocedural assessment with multidetector computed tomography

Vikram Kurra, Paul Schoenhagen, Eric E. Roselli, Samir R. Kapadia, E. Murat Tuzcu, Roy Greenberg, Mateen Akhtar, Milind Y. Desai, Scott D. Flamm, Sandra S. Halliburton, Lars G. Svensson, Srikanth Sola

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Percutaneous aortic valve insertion is an emerging treatment option for selected patients with severe aortic stenosis and may be done from a transfemoral or transapical approach. Concomitant atherosclerotic peripheral artery disease limits transfemoral access. We evaluated the potential role of multidetector computed tomography in preoperative assessment of vascular anatomy. Methods: Consecutive patients with severe aortic stenosis were included. Contrast-enhanced computed tomographic angiography of the thoracic and abdominal aorta and iliofemoral arteries was performed. Criteria of unfavorable iliofemoral anatomy were defined as a minimal luminal diameter of the common iliac, external iliac, or common femoral arteries of less than 8 mm, presence of greater than 60% circumferential calcification at the external-internal iliac bifurcation, and severe angulation between the common and external iliac arteries (<90°). The prevalence of these criteria was evaluated and infrarenal aortic and iliofemoral arterial anatomy was compared in the groups with and without peripheral artery disease for any of these criteria. Results: One hundred patients (79 ± 9 years, 59% male) were included. A total of 35 (35%) patients had at least one criterion of unsuitable iliofemoral anatomy, including 27 patients with small minimal luminal diameter (60%), and 4 with severe angulation of the iliac arteries (

Original languageEnglish (US)
Pages (from-to)1258-1264
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume137
Issue number5
DOIs
StatePublished - May 2009
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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