The Role of Cerebral Embolic Protection Devices During Transcatheter Aortic Valve Replacement
Key result
Cerebral embolic protection devices reduce cerebral infarct volume during transcatheter aortic valve replacement, but their impact on clinically evident ischemic strokes remains unclear.
Why the study?
Do cerebral embolic protection devices reduce the risk of peri-procedural ischemic stroke in patients undergoing transcatheter aortic valve replacement?
Population
Patients with severe aortic stenosis who have prohibitive or high surgical risk undergoing transcatheter…
Design
Systematic_review
Authors
Discussion
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Member takes
Implication
Does not support routine cerebral embolic protection in TAVR; leaves open whether clinical stroke reduction justifies adoption.
Structured PICO
Do cerebral embolic protection devices reduce the risk of peri-procedural ischemic stroke in patients undergoing transcatheter aortic valve replacement?
P
Population
Patients with severe aortic stenosis who have prohibitive or high surgical risk undergoing transcatheter aortic valve replacement (TAVR)
I
Intervention
Cerebral embolic protection devices (CEPD) during TAVR
O
Outcome
Peri-procedural ischemic stroke and intraprocedural burden of new silent ischemic injuryhard clinical
This systematic review evaluates the current evidence for using cerebral embolic protection devices to minimize peri-procedural stroke risk during TAVR.
Limitations
- Individual studies lack statistical power to evaluate clinical stroke endpoints
- Heterogeneity in timing of DW-MRI evaluation across studies
- Incomplete protection of all brain territories by some devices
Cite This Study
Demir et al. (2018) conducted a review in Severe aortic stenosis undergoing Transcatheter Aortic Valve Replacement (TAVR). Cerebral Embolic Protection Devices (CEPD) vs. Unprotected TAVR was evaluated. Cerebral embolic protection devices reduce cerebral infarct volume during transcatheter aortic valve replacement, but their impact on clinically evident ischemic strokes remains unclear.