- 作者：Paul T.L. Chiam ; Angela S. Koh ; See Hooi Ewe ; Yoong Kong Sin ; Victor T.T. Chao ; Choo Khong Ng ; Chung Yin Lee ; Yeong Phang Lim ; Jang Wen Su ; See Lim Lim ; Teing Ee Tan ; Chong Hee Lim ; Swee Yaw Tan ; Soo Teik Lim ; Terrance S.J. Chua ; Tian Hai Koh ; Yeow Leng Chua
- 关键词：Aortic valve stenosis ; Percutaneous ; Valve implantation ; Iliac artery ; Femoral artery ; Asian
- 刊名：International Journal of Cardiology
- 出版年：2013
- 出版时间：20 August, 2013
- 年：2013
- 卷：167
- 期：4
- 页码：1373-1379
- 全文大小：410 K
Background/objectives
This study aims to examine iliofemoral anatomy and predictors of vessel size and tortuosity in Asian patients as transfemoral transcatheter aortic valve implantation (TAVI) may be limited by the smaller Asian physique.Methods
Characteristics and vessel dimensions of 549 patients undergoing ultrasonography were reviewed. The minimal luminal diameter (MLD) along the iliofemoral vasculature of each side was identified and the larger of the two sides was used to determine suitability for transfemoral TAVI.
Results
The mean age was 66 ¡À 11 years (68 % males). Mean iliac MLD was 7.6 ¡À 1.7 mm, females smaller than males (7.2 ¡À 1.7 vs 7.8 ¡À 1.7, p < 0.001). Mean iliac MLD decreased with age: 7.9 ¡À 1.7 mm, 7.4 ¡À 1.9 mm and 7.3 ¡À 1.6 mm for ages < 70 years, 70-79 years and ¡Ý 80 years respectively (p = 0.038). Mean femoral MLD was 7.0 ¡À 1.7 mm, females smaller than males (6.3 ¡À 1.5 mm vs 7.3 ¡À 1.8 mm, p < 0.001). Females were more likely than males to have iliac and femoral MLD < 6 mm (20 % vs 12 % , p = 0.019 and 34 % vs 21 % , p = 0.001). Independent predictors of smaller iliofemoral dimensions were female gender, lower body surface area, diabetes mellitus, dyslipidemia and smoking history. Significant iliac tortuosity was present in 11.8 % , more frequent in males than females (15 % vs 6 % , p = 0.005), and in those with logistic EuroSCORE ¡Ý 15 than < 15 (27 % vs 10 % , p = 0.001).
Conclusions
This study establishes the mean iliac and femoral artery diameters in a cohort of relatively young Asian patients. Age and female gender were associated with smaller vessel dimension and several independent predictors of smaller vasculature and tortuosity were identified. These results have implications for TF TAVI in Asia.