Transkatheter

Transkatheter, or transcatheter in English, refers to medical procedures performed by threading a catheter through the vascular system to reach a target site within the heart, blood vessels, or other organs. Transcatheter techniques enable minimally invasive intervention and are performed in specialized centers by multidisciplinary teams.

Common transcatheter procedures address cardiovascular disease and other conditions. Transcatheter aortic valve replacement (TAVR or TAVI) delivers a replacement aortic valve via a catheter to the valve position. Transcatheter mitral valve interventions include repair or replacement techniques delivered through the vasculature. Endovascular transcatheter approaches treat vascular disease, such as aneurysm repair, dissection management, and embolization or occlusion of targeted vessels. Balloon valvuloplasty expands narrowed valves. Many transcatheter therapies aim to reduce the need for open-heart surgery, especially in patients with high operative risk.

Access routes vary by procedure and anatomy, often involving the femoral artery or vein, but can include radial, brachial, or other approaches. Device design and procedural imaging have evolved to improve accuracy, reduce complications, and expand indications. Potential risks are largely related to the access route and device interaction, including vascular injury, bleeding, infection, stroke, heart block requiring pacing, and device-related complications such as paravalvular leak or valve malposition.

History and development began in the late 20th century, with the first transcatheter aortic valve implantation performed in 2002 by Alain Cribier. Since then, advances in devices, imaging, and operator experience have broadened the range of conditions treatable by transcatheter techniques and improved patient outcomes.