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Clinical impact of cerebral protection during transcatheter aortic valve implantation.
- Source :
-
European journal of clinical investigation [Eur J Clin Invest] 2024 May; Vol. 54 (5), pp. e14166. Date of Electronic Publication: 2024 Jan 25. - Publication Year :
- 2024
-
Abstract
- Background: Embolization of debris can complicate transcatheter aortic valve implantation (TAVI) causing stroke. Cerebral embolism protection (CEP) devices can divert or trap debris.<br />Purpose: To evaluate the efficacy of CEP during TAVI vs the standard procedure.<br />Data Sources: PubMed, SCOPUS and DOAJ 1/01/2014-04/12/2023.<br />Study Selection: Randomized and observational studies comparing CEP versus standard TAVI, according to PRISMA.<br />Primary Outcome: stroke.<br />Secondary Outcomes: death, bleeding, vascular access complications, acute kidney injury and infarct area.<br />Data Extraction: Two investigators independently assessed study quality and extracted data.<br />Data Synthesis: Twenty-six articles were included (540.247 patients). The primary endpoint was significantly lower (RR = 0.800 95%CI:0.682-0.940; p = 0.007) with CEP. Similarly, death rates were significantly lower with CEP (RR = 0.610 95%CI:0.482-0.771; p < 0.001). No difference was found for bleeding (RR = 1.053 95%CI:0.793-1.398; p = 0.721), vascular complications (RR = 0.937 95%CI:0.820-1.070; p = 0.334) or AKI (RR = 0.982 95%CI:0.754-1.279; p = 0.891).<br />Conclusions: Use of CEP during TAVI is associated with improved outcomes. Future studies will identify patients who benefit most from CEP.<br /> (© 2024 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
- Subjects :
- Humans
Aortic Valve surgery
Observational Studies as Topic
Randomized Controlled Trials as Topic
Risk Factors
Treatment Outcome
Aortic Valve Stenosis surgery
Aortic Valve Stenosis complications
Heart Valve Prosthesis Implantation adverse effects
Stroke prevention & control
Stroke etiology
Transcatheter Aortic Valve Replacement adverse effects
Transcatheter Aortic Valve Replacement methods
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2362
- Volume :
- 54
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European journal of clinical investigation
- Publication Type :
- Academic Journal
- Accession number :
- 38269600
- Full Text :
- https://doi.org/10.1111/eci.14166