Multicentre International Registry of Open Surgical Versus Percutaneous Upper Extremity Access During Endovascular Aortic Procedures

To investigate access failure (AF) and stroke rates of aortic procedures performed with upper extremity (UEA), compare results open surgical vs. percutaneous UEA techniques closure devices. A physician initiated, multicentre, ambispective, observational registry (SUPERAXA - NCT04589962) was carried out patients undergoing requiring UEA, including transcatheter valve replacement, arch, thoraco-abdominal endovascular repair, pararenal parallel grafts, renovisceral iliac vessel repair. Only vascular an or (with a suture mediated device) were analysed. Risk factors endpoints classified according to the Society for Vascular Surgery VARC-3 (Valve Academic Research Consortium) reporting standards. logistic regression model used identify AF risk predictors, propensity matching employed techniques. Sixteen centres registered 1 098 (806 men [73.4%]; median age 74 years, interquartile range 69 – 79 years) using (76%) (24%) UEA. Overall 6.8% 3.0%, respectively. Independent predictors by multivariable analysis included pacemaker ipsilateral (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.2 12.1; p = .026), branched fenestrated procedure (OR 3.4, CI 9.6; .019) introducer internal diameter ≥ 14 F 6.6, 2.1 20.7; .001). Stroke associated female sex 1.3 9.0; .013), > 7 mm 3.9, 1.1 13.8; .037), arch 7.3, 1.7 31.1; .007). After 1:1 matching, there no difference between cohorts. However, statistically significantly higher number adjunctive recorded in cohort (p < during complex employing are non-negligible. Therefore, selective use is warranted. Percutaneous devices similar complication rates, but more required avoid exposure.