Vascular Access Management in Transcatheter Aortic Valve Implantation

Though transcatheter aortic valve implantation (TAVI) has given ample proof of being a safe procedure, it is not devoid of complications. Peripheral vascular complications and bleeding at the access site are still among the problems most frequently associated with transfemoral TAVI. The transfemoral route is the access of first choice, and the improvement of TAVI devices has made it possible to reduce the size of introducers and delivery systems from the initial 22–24 Fr of the early devices to 18 Fr, first, and now to the 14–16 Fr of many new-generation devices. This has made it possible to broaden the range of indications treated with the transfemoral approach to serve a larger number of patients.