It has been demonstrated that a subclavian approach leads to morbidity and mortality rates similar to those observed with the transfemoral approach [61]. CTA can also be used to evaluate alternate access sites like direct aortic or subclavian/axillary access. Arnett et al retrospectively evaluated 208 patients undergoing CTA and reported on the compared axillary arteries and demonstrated substantially lower rates of significant stenosis (2% Transcatheter Aortic Valve Replacement versus 12%, P < . 01) and significantly lower rates of moderate to severe calcification disease (9% versus 64%, P < . 01) than iliofemoral arteries [60]. MRA Abdomen and Pelvis Without and With IV Contrast There is limited data supporting MRA abdomen and pelvis without and with IV contrast as the initial imaging modality for the evaluation of vascular access before a TAVR procedure. MRA Chest, Abdomen, and Pelvis With IV Contrast There is no relevant literature supporting the use of MRA chest, abdomen, and pelvis with IV contrast for the assessment of supra ventricular aorta and vascular access. MRA chest, abdomen, and pelvis with IV contrast can; however, be used as an alternate option in a selected patient population to assess supravalvular aorta and vascular access. MRA Chest With and Without IV Contrast There is no relevant literature supporting the use of MRA chest with and without IV contrast for the assessment of supra ventricular aorta and vascular access; however, MRA chest with and without IV contrast can be used as an alternate option in a selected patient population to assess supravalvular aorta and vascular access. US Duplex Doppler Chest, Abdomen, and Pelvis There is no relevant literature to support the use of US duplex doppler chest, abdomen, and pelvis as the initial imaging modality for evaluation of vascular access before a TAVR procedure.
Preprocedural Planning for Transcatheter Aortic Valve Replacement. It has been demonstrated that a subclavian approach leads to morbidity and mortality rates similar to those observed with the transfemoral approach [61]. CTA can also be used to evaluate alternate access sites like direct aortic or subclavian/axillary access. Arnett et al retrospectively evaluated 208 patients undergoing CTA and reported on the compared axillary arteries and demonstrated substantially lower rates of significant stenosis (2% Transcatheter Aortic Valve Replacement versus 12%, P < . 01) and significantly lower rates of moderate to severe calcification disease (9% versus 64%, P < . 01) than iliofemoral arteries [60]. MRA Abdomen and Pelvis Without and With IV Contrast There is limited data supporting MRA abdomen and pelvis without and with IV contrast as the initial imaging modality for the evaluation of vascular access before a TAVR procedure. MRA Chest, Abdomen, and Pelvis With IV Contrast There is no relevant literature supporting the use of MRA chest, abdomen, and pelvis with IV contrast for the assessment of supra ventricular aorta and vascular access. MRA chest, abdomen, and pelvis with IV contrast can; however, be used as an alternate option in a selected patient population to assess supravalvular aorta and vascular access. MRA Chest With and Without IV Contrast There is no relevant literature supporting the use of MRA chest with and without IV contrast for the assessment of supra ventricular aorta and vascular access; however, MRA chest with and without IV contrast can be used as an alternate option in a selected patient population to assess supravalvular aorta and vascular access. US Duplex Doppler Chest, Abdomen, and Pelvis There is no relevant literature to support the use of US duplex doppler chest, abdomen, and pelvis as the initial imaging modality for evaluation of vascular access before a TAVR procedure.