Utility of Cerebral Embolic Protection Devices in Transcatheter Procedures: A Systematic Review and Meta-Analysis
Source : https://www.sciencedirect.com/science/article/abs/pii/S0146280623000920?via=ihub
Available online 3 March 2023, 101675 Author links open overlay panel Zulfiqar Qutrio Baloch MD 1 , , Hasan Fareed Siddiqui 3 , Fahd Niaz Shaikh 3 , , , Show more With the emergence of the largest randomized control trial to date - the Stroke Protection With Sentinel During Transcatheter Aortic Valve Replacement (PROTECTED TAVR) study- we sought to conduct an updated meta-analyses to evaluate the utility of CEP devices on both clinical outcomes and neuroimaging parameters.
Conclusions: The results suggest that CEP device use was associated with a lower risk of disabling stroke and bleeding events in patients undergoing TAVR.
• Source: Current Problems in Cardiology
• Conclusions: “The results suggest that CEP [cerebral embolic protection] device use was associated with a lower risk of disabling stroke and bleeding events in patients undergoing TAVR.”
• Due to the publication of results from the largest randomized control trial to date, or the Stroke Protection With Sentinel During Transcatheter Aortic Valve Replacement (PROTECTED TAVR) study, the authors performed a meta-analyses to evaluate the usefulness of CEP devices.
• In the current systematic review and meta-analysis, U.S. and international researchers included 13 studies (8 RCTs, 5 observational; n=128,000+). They found a significant decrease in stroke (OR: ; P < 0.01) and bleeding events (OR: 0.91; P = 0.04) when using a CEP device in TAVR. CEP did not impact rates of non-disabling stroke, mortality, vascular complications, acute kidney injury, new ischemic lesions, and total lesion volume.
• The authors wrote, “Periprocedural embolizations from the valve or vasculature can result in stroke—both disabling and non-disabling—resulting in increased mortality and morbidity. To combat this risk, cerebral embolic protection (CEP) devices were developed to filter or deflect emboli during the procedure.”