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Type: Journal article
Title: Aortic atheroma burden predicts acute cerebrovascular events after transcatheter aortic valve implantation: insights from volumetric multislice computed tomography analysis
Author: Kataoka, Y.
Puri, R.
Pisaniello, A.
Hammadah, M.
Qintar, M.
Uno, K.
Montarello, J.
Nicholls, S.
Worthley, S.
Citation: EuroIntervention, 2016; 12(6):783-789
Publisher: Europa Group
Issue Date: 2016
ISSN: 1774-024X
Statement of
Yu Kataoka, Rishi Puri, Anthony D. Pisaniello, Muhammad Hammadah, Mohammed Qintar, Kiyoko Uno, Joseph K. Montarello, Stephen J. Nicholls, Stephen G. Worthley
Abstract: Aims: Embolisation of atheromatous debris during catheter manipulation is considered to underlie acute cerebrovascular events (CVE) after transcatheter aortic valve implantation (TAVI). However, the relationship between aorta atheroma burden and acute CVE after TAVI has not been established. We investigated the impact of aorta atheroma burden on acute CVE. Methods and Results: Preoperative multislice computed tomographic (MSCT) images in 278 patients receiving TAVI were analysed. Total atheroma volume (TAV) was calculated by measuring aorta vessel and lumen areas in every 1 mm cross-sectional image. Acute CVE was observed in 16 patients. Patients having acute CVE were more likely to have a prior CVE (p=0.002), and to exhibit greater TAV in the ascending aorta (12.8±3.5 vs. 7.0±2.1 cm3, p<0.001) and the aortic arch (3.1±1.6 vs. 1.2±0.2 cm3, p<0.001). TAV in the ascending aorta >10.3 cm3 and in the aortic arch >2.9 cm3 predicted acute CVE. The incidence of acute CVE was highest (36.4%) if patients had a prior CVE and TAV in the ascending aorta and the aortic arch above cut-offs. Conclusions: Patients with acute CVE after TAVI had greater aorta atheroma burden. Our findings might underscore preoperative MSCT analysis of aorta atherosclerosis to identify high-risk patients for acute CVE, who might require an embolic protection device during TAVI.
Keywords: Atherosclerosis; stroke; aortic valve stenosis; computed tomography; aortic valve implantation
Rights: Copyright status unknown
RMID: 0030052277
DOI: 10.4244/EIJV12I6A127
Appears in Collections:Medicine publications

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