SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study)

The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and the percutaneous (PC) approach. In the matched population, 15 out of 323 patients (4.6 percent) in the SC group versus 34 out of 323 patients in the PC group (11 percent) experienced minor vascular complications (p = 0.02). There was no significant difference for major vascular complications, with rates of 1.5 percent and 1.9 percent. The rate of minor bleeding events was higher in the percutaneous group (11 percent versus 3.1 percent, p <.001). The SC group also experienced a higher rate of non-vascular-related access complications, with minor complications at 8 percent versus 1.2 percent and major complications at 2.2 percent versus 1.2 percent (p < 0.001). Surgical cut-down for TF-TAVI did not alter the 30-day mortality rate and was associated with reduced minor vascular complications and bleeding. The PC approach showed a lower rate of non-vascular-related access complications and a shorter length of stay. The choice of approach should be tailored to the patient's clinical characteristics.