Iliofemoral anatomy among Asians: Implications for transcatheter aortic valve implantation.

Chiam Paul, Koh AS, Ewe SH, Sin YK, Chao VT, Ng CK, Lee CY, Lim YP, Su JW, Lim SL, Tan TE, Lim CH, Tan SY, Lim ST, Chua TS, Koh TH, Chua YL.  

International Journal of Cardiology 2013; 167: 1373-9



This study aims to examine iliofemoral anatomy and predictors of vessel size and tortuosity in Asian patients as transfemoral transcatheter aortic valve implantation (TAVI) may be limited by the smaller Asian physique.


Characteristics and vessel dimensions of 549 patients undergoing ultrasonography were reviewed. The minimal luminal diameter (MLD) along the iliofemoral vasculature of each side was identified and the larger of the two sides was used to determine suitability for transfemoral TAVI.


The mean age was 66 ± 11 years (68% males). Mean iliac MLD was 7.6 ± 1.7 mm, females smaller than males (7.2 ± 1.7 vs 7.8 ± 1.7, p<0.001). Mean iliac MLD decreased with age: 7.9 ± 1.7 mm, 7.4 ± 1.9 mm and 7.3 ± 1.6mm for ages <70 years, 70-79 years and ≥ 80 years respectively (p=0.038). Mean femoral MLD was 7.0 ± 1.7 mm, females smaller than males (6.3 ± 1.5mm vs 7.3 ± 1.8mm, p<0.001). Females were more likely than males to have iliac and femoral MLD <6mm (20% vs 12%, p=0.019 and 34% vs 21%, p=0.001). Independent predictors of smalleriliofemoral dimensions were female gender, lower body surface area, diabetes mellitus, dyslipidemia and smoking history. Significant iliac tortuosity was present in 11.8%, more frequent in males than females (15% vs 6%, p=0.005), and in those with logistic EuroSCORE ≥ 15 than <15 (27% vs 10%, p=0.001).


This study establishes the mean iliac and femoral artery diameters in a cohort of relatively young Asian patients. Age and female gender were associated with smaller vessel dimension and several independent predictors of smaller vasculature and tortuosity were identified. These results have implications for TF TAVI in Asia.

Contact Us

Input this code: captcha

The Heart & Vascular Centre
3 Mount Elizabeth #08-06
Mount Elizabeth Medical Centre
Singapore 228510
T: (65) 6735 3022
F: (65) 6735 3021
After hours: (65) 9664 0822
* Directions

The Heart & Vascular Centre (Novena)
38 Irrawaddy Road #09-21
Mt Elizabeth Novena Specialist Centre
Singapore 329563
T: (65) 6694 0140
F: (65) 6694 0150
After hours: (65) 9236 1026
* Directions


+65 6735 3022

Call Us Now!

For an appointment.