Dynamic Sheaths, in the Nick of Time or Past Their Prime?

Risk factors for vascular complications include a sheath to femoral artery ratio (SFAR) > 1.05, use of sheaths >19 Fr, peripheral artery disease, female gender, and a learning curve. High rates of technical and procedural success were achieved with low rates of major vascular and bleeding complications. However, SFAR > 1.05, gender, diabetes, renal insufficiency, calcification, tortuosity, or aneurysm were not independent risk factors in this study. Despite an SFAR > 1.05 in 23 patients, increased rates of vascular complications were not seen using the SoloPath sheath. These findings may increase the pool of transfemoral TAVI patients.