SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement

Matthew Sherwood; Keith B. Allen; Thom G. Dahle; Chandan M. Devireddy; Jeffrey Gaca; Santiago Garcia; Kendra J. Grubb; Tsuyoshi Kaneko; Chad A. Kliger; Robert J. Lederman; John C. Messenger; Puja B. Parikh; Marie France Poulin; Carlos Sanchez; Anene Ukaigwe; James J. Yun; Paul D. Mahoney

doi:10.1016/j.jscai.2024.102514

SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement

Matthew Sherwood, Keith B. Allen, Thom G. Dahle, Chandan M. Devireddy, Jeffrey Gaca, Santiago Garcia, Kendra J. Grubb, Tsuyoshi Kaneko, Chad A. Kliger, Robert J. Lederman, John C. Messenger, Puja B. Parikh, Marie France Poulin, Carlos Sanchez, Anene Ukaigwe, James J. Yun, Paul D. Mahoney

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Abstract

Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR.

Original language	English
Article number	102514
Journal	Journal of the Society for Cardiovascular Angiography and Interventions
Volume	4
Issue number	3
DOIs	https://doi.org/10.1016/j.jscai.2024.102514
State	Published - Mar 2025

Keywords

alternative access
transcarotid
transcatheter aortic valve replacement
transcaval
vascular access

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10.1016/j.jscai.2024.102514

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Sherwood, M., Allen, K. B., Dahle, T. G., Devireddy, C. M., Gaca, J., Garcia, S., Grubb, K. J., Kaneko, T., Kliger, C. A., Lederman, R. J., Messenger, J. C., Parikh, P. B., Poulin, M. F., Sanchez, C., Ukaigwe, A., Yun, J. J., & Mahoney, P. D. (2025). SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement. Journal of the Society for Cardiovascular Angiography and Interventions, 4(3), Article 102514. https://doi.org/10.1016/j.jscai.2024.102514

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title = "SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement",

abstract = "Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR.",

keywords = "alternative access, transcarotid, transcatheter aortic valve replacement, transcaval, vascular access",

author = "Matthew Sherwood and Allen, {Keith B.} and Dahle, {Thom G.} and Devireddy, {Chandan M.} and Jeffrey Gaca and Santiago Garcia and Grubb, {Kendra J.} and Tsuyoshi Kaneko and Kliger, {Chad A.} and Lederman, {Robert J.} and Messenger, {John C.} and Parikh, {Puja B.} and Poulin, {Marie France} and Carlos Sanchez and Anene Ukaigwe and Yun, {James J.} and Mahoney, {Paul D.}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = mar,

doi = "10.1016/j.jscai.2024.102514",

language = "English",

volume = "4",

journal = "Journal of the Society for Cardiovascular Angiography and Interventions",

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Sherwood, M, Allen, KB, Dahle, TG, Devireddy, CM, Gaca, J, Garcia, S, Grubb, KJ, Kaneko, T, Kliger, CA, Lederman, RJ, Messenger, JC, Parikh, PB, Poulin, MF, Sanchez, C, Ukaigwe, A, Yun, JJ & Mahoney, PD 2025, 'SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement', Journal of the Society for Cardiovascular Angiography and Interventions, vol. 4, no. 3, 102514. https://doi.org/10.1016/j.jscai.2024.102514

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AU - Sherwood, Matthew

AU - Allen, Keith B.

AU - Dahle, Thom G.

AU - Devireddy, Chandan M.

AU - Gaca, Jeffrey

AU - Garcia, Santiago

AU - Grubb, Kendra J.

AU - Kaneko, Tsuyoshi

AU - Kliger, Chad A.

AU - Lederman, Robert J.

AU - Messenger, John C.

AU - Parikh, Puja B.

AU - Poulin, Marie France

AU - Sanchez, Carlos

AU - Ukaigwe, Anene

AU - Yun, James J.

AU - Mahoney, Paul D.

PY - 2025/3

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AB - Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR.

KW - alternative access

KW - transcarotid

KW - transcatheter aortic valve replacement

KW - transcaval

KW - vascular access

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IS - 3

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ER -

SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement

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