Regarding “Rapid development of an iatrogenic aortic dissection following transcatheter aortic valve implantation”

we read with interest the paper by geile and colleagues [1], and we would like to clarify some crucial points. nowadays, the great majority of TAVI cases are performed through a trans-femoral (TF) access due to this technique having several advantages: it is completely percutaneous and it allows a quick and almost painless postoperative recovery. However, the most important drawback of TF-TAVI, as well as other types of trans-vascular accesses, is that it is based on a retrograde navigation through the vascular system with a potential risk of atherosclerotic plaque displacement causing distal embolization as well as plaque rupture resulting in aortic dissection.