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Clinical impact of cerebral protection during transcatheter aortic valve implantation.

Authors :
Boccuto F
Carabetta N
Cacia MA
Kanagala SG
Panuccio G
Torella D
De Rosa S
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.)

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