How true delivery profile diminution reduces vascular access challenges and complications

Transcatheter aortic valve implantation (TAVI ) is the treatment of choice among patients with symptomatic severe aortic stenosis (AS) deemed inoperable and a valuable alternative to surgical aortic valve replacement for high-risk surgical patients. Over the years, this procedure proved to be relatively safe, but despite this complications may occur. When performing TAVI , the most frequent complications are represented by peripheral vascular complications and bleeding involving the access site. Trans-femoral (TF) route is the preferred access site and device evolution has made it possible to reduce in size sheaths and delivery systems from the initial 22- to 24-Fr of the first generation TF devices, progressively down to 18-Fr and then to 16-14-Fr with the latest generations of prostheses, with a required minimal lumen diameter (MLD) of 5.5 mm. The more vascular-friendly TF-TAVI devices, not only have made it possible to patients with small arteries to be treated with this procedure, but also have markedly reduced vascular complications