Clinical impact of cerebral protection during transcatheter aortic valve implantation.
Eur J Clin Invest
; 54(5): e14166, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38269600
ABSTRACT
BACKGROUND:
Embolization of debris can complicate transcatheter aortic valve implantation (TAVI) causing stroke. Cerebral embolism protection (CEP) devices can divert or trap debris.PURPOSE:
To evaluate the efficacy of CEP during TAVI vs the standard procedure. DATA SOURCES PubMed, SCOPUS and DOAJ 1/01/2014-04/12/2023. STUDY SELECTION Randomized and observational studies comparing CEP versus standard TAVI, according to PRISMA. PRIMARYOUTCOME:
stroke. SECONDARYOUTCOMES:
death, bleeding, vascular access complications, acute kidney injury and infarct area. DATA EXTRACTION Two investigators independently assessed study quality and extracted data. DATASYNTHESIS:
Twenty-six articles were included (540.247 patients). The primary endpoint was significantly lower (RR = 0.800 95%CI0.682-0.940; p = 0.007) with CEP. Similarly, death rates were significantly lower with CEP (RR = 0.610 95%CI0.482-0.771; p < 0.001). No difference was found for bleeding (RR = 1.053 95%CI0.793-1.398; p = 0.721), vascular complications (RR = 0.937 95%CI0.820-1.070; p = 0.334) or AKI (RR = 0.982 95%CI0.754-1.279; p = 0.891).CONCLUSIONS:
Use of CEP during TAVI is associated with improved outcomes. Future studies will identify patients who benefit most from CEP.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
1_doencas_nao_transmissiveis
/
2_muertes_prematuras_enfermedades_notrasmisibles
/
6_cardiovascular_diseases
/
6_cerebrovascular_disease
Assunto principal:
Estenose da Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
/
Acidente Vascular Cerebral
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Eur J Clin Invest
/
Eur. j. clin. invest
/
European journal of clinical investigation
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Itália