Shockwave Intravascular Lithotripsy in Preference to Alternate Vascular Access to Facilitate Transfemoral Vascular Access for Transcatheter Aortic Valve Implantation

Abstract

Transfemoral access for transcatheter aortic valve implantation (TAVI) is not always feasible owing to hostile peripheral anatomy. In the early era of TAVI, direct aortic/transapical approaches were used as alternative access techniques; however, these approaches have been largely abandoned owing to inferior patient outcomes [1]. Subsequently, a number of novel alternate-access techniques have emerged, including subclavian, axillary, carotid, and transcaval approaches. More recently, shockwave intravascular lithotripsy (IVL) has offered a novel approach to facilitate the preferred transfemoral approach to TAVI procedures.