Non-femoral TAVR: Time to stratify alternative vascular approaches.

Although transfemoral transcatheter aortic valve replacement (TAVR) is the gold standard, this approach is not be feasible in approximately 15% of the patients. Trans-carotid TAVR may be less invasive than transthoracic routes for TAVR, and has been associated with encouraging results. Further prospective studies comparing alternative access routes in patients with whom transfemoral TAVR is not feasible are warranted, to propose an evidence-based algorithm guiding the physician decision.