Mazhed Kheyrbek, Sam Alsabti, Shailesh Niroula, Ela Ahmad, Mustapha Choucair, Unnati Bhatia, Adam Wernette, Karan Chhabra, Kateryna Strubchevska, Ivan Hanson, Alexandra Halalau
{"title":"Safety and efficacy of cerebral embolic protection systems in transcatheter aortic valve replacement: a systematic review and meta-analysis.","authors":"Mazhed Kheyrbek, Sam Alsabti, Shailesh Niroula, Ela Ahmad, Mustapha Choucair, Unnati Bhatia, Adam Wernette, Karan Chhabra, Kateryna Strubchevska, Ivan Hanson, Alexandra Halalau","doi":"10.1080/14779072.2024.2445256","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Stroke is a potential complication of Transcatheter Aortic Valve Replacement (TAVR). Recent trials evaluating Cerebral Embolic Protection Systems (CEPS) to reduce the incidence of stroke after TAVR have been conflicting.</p><p><strong>Methods: </strong>Multiple databases were searched for studies comparing TAVR with or without CEPS and that reported on the primary outcome of periprocedural stroke. Two authors individually screened the titles, the abstracts and the full texts using Covidence. Risk of bias was assessed using Cochrane's ROB-2 and ROBINS-I tools.</p><p><strong>Results: </strong>A total of 15 studies (3 randomized controlled trials, 7 national registries, and 5 cohort studies) met the eligibility criteria and were included in our review. CEPS was associated with lower rates of periprocedural stroke [OR 0.71 (95% CI 0.55, 0.93) <i>p</i> = 0.012], as well as lower rates of mortality [OR 0.60 (95% CI 0.49, 0.74) <i>p</i> < 0.001]. There was no significant difference between the two groups in the incidence of acute kidney injury [OR 0.91 (95% CI 0.82, 1.01) <i>p</i> = 0.087], major vascular complications [OR 0.97 (95% CI 0.83, 1.14) <i>p</i> = 0.734], and major life-threatening bleeding [OR 0.89 (95% CI 0.73, 1.07) <i>p</i> = 0.222].</p><p><strong>Conclusions: </strong>Our findings suggest that the use of CEPS in TAVR is associated with a lower risk of periprocedural stroke and mortality.</p><p><strong>Registration: </strong>The PROSPERO identification number is CRD42022374055.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":1.8000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Cardiovascular Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14779072.2024.2445256","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Safety and efficacy of cerebral embolic protection systems in transcatheter aortic valve replacement: a systematic review and meta-analysis.
Background: Stroke is a potential complication of Transcatheter Aortic Valve Replacement (TAVR). Recent trials evaluating Cerebral Embolic Protection Systems (CEPS) to reduce the incidence of stroke after TAVR have been conflicting.
Methods: Multiple databases were searched for studies comparing TAVR with or without CEPS and that reported on the primary outcome of periprocedural stroke. Two authors individually screened the titles, the abstracts and the full texts using Covidence. Risk of bias was assessed using Cochrane's ROB-2 and ROBINS-I tools.
Results: A total of 15 studies (3 randomized controlled trials, 7 national registries, and 5 cohort studies) met the eligibility criteria and were included in our review. CEPS was associated with lower rates of periprocedural stroke [OR 0.71 (95% CI 0.55, 0.93) p = 0.012], as well as lower rates of mortality [OR 0.60 (95% CI 0.49, 0.74) p < 0.001]. There was no significant difference between the two groups in the incidence of acute kidney injury [OR 0.91 (95% CI 0.82, 1.01) p = 0.087], major vascular complications [OR 0.97 (95% CI 0.83, 1.14) p = 0.734], and major life-threatening bleeding [OR 0.89 (95% CI 0.73, 1.07) p = 0.222].
Conclusions: Our findings suggest that the use of CEPS in TAVR is associated with a lower risk of periprocedural stroke and mortality.
Registration: The PROSPERO identification number is CRD42022374055.
期刊介绍：
Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
