• Cerebral embolic protection de...

Treffer: Cerebral embolic protection devices in transcatheter aortic valve implantation: a systematic review and meta-analysis of randomized controlled trials.

Title:
Cerebral embolic protection devices in transcatheter aortic valve implantation: a systematic review and meta-analysis of randomized controlled trials.
Authors:
Waseem MH; Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan., Ul Abideen Z; Department of Medicine, King Edward Medical University, Lahore, Pakistan., Cheema AH; Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA., Osama M; Department of Medicine, Hayatabad Medical Complex Peshawar, Peshawar, Pakistan., Javed Khan H; Department of Medicine, King Edward Medical University, Lahore, Pakistan., Farid R; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Rehman N; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Aimen S; Department of Medicine, Quetta Institute of Medical Sciences, Quetta, Pakistan., Thada PK; Department of Medicine, Sotang Primary Hospital, Sotang, Nepal.
Source:
Expert review of medical devices [Expert Rev Med Devices] 2026 Jan; Vol. 23 (1), pp. 59-68. Date of Electronic Publication: 2025 Dec 01.
Publication Type:
Journal Article; Systematic Review; Meta-Analysis; Review
Language:
English
Journal Info:
Publisher: Taylor & Francis Country of Publication: England NLM ID: 101230445 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1745-2422 (Electronic) Linking ISSN: 17434440 NLM ISO Abbreviation: Expert Rev Med Devices Subsets: MEDLINE
Imprint Name(s):
Publication: 2015- : Abingdon, Oxford : Taylor & Francis
Original Publication: London : Future Drugs Ltd.
MeSH Terms:
Transcatheter Aortic Valve Replacement*/adverse effects , Transcatheter Aortic Valve Replacement*/instrumentation , Embolic Protection Devices* , Intracranial Embolism*/prevention & control , Intracranial Embolism*/etiology, Humans ; Randomized Controlled Trials as Topic ; Stroke/prevention & control ; Stroke/etiology
Contributed Indexing:
Keywords: Transcatheter aortic valve replacement; cerebral embolic protection; emboli protection device; stroke; transcatheter aortic valve implantation
Entry Date(s):
Date Created: 20251127 Date Completed: 20260114 Latest Revision: 20260116
Update Code:
20260116
DOI:
10.1080/17434440.2025.2595252
PMID:
41307539
Database:
MEDLINE

Weitere Informationen

Background: This meta-analysis aimed to assess the efficacy and safety of cerebral embolic protection devices (CEPDs) in patients undergoing transcatheter aortic valve implantation (TAVI).
Methods: PubMed, Cochrane Central, and ScienceDirect were searched till April 2025. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled under a random-effects model using Review Manager. The Cochrane risk of bias (RoB 2.0) tool was used for quality assessment. Funnel plots were assessed for publication bias.
Results: Eight randomized controlled trials, including 11,632 patients undergoing TAVI, were analyzed. Use of CEPDs showed a non-significant reduction in all strokes (RR 0.92, 95% CI: 0.74-1.15, p  = 0.48) and disabling stroke (RR 0.80, 95% CI: 0.57-1.12, p  = 0.18). There was no significant difference in all-cause mortality (RR 1.09, 95% CI: 0.71-1.67, p  = 0.70), acute kidney injury (AKI) (RR 0.96, 95% CI: 0.44-2.11, p  = 0.93), disabling bleeding (RR 0.96, 95% CI: 0.28-3.31; p  = 0.94) and major vascular complications (RR 1.25, 95% CI: 0.56-2.78, p  = 0.59).
Conclusion: CEPD did not significantly reduce the incidence of ischemic lesions or neurocognitive decline. Current evidence does not support a statistically significant clinical benefit of CEPD use during TAVI. While trends suggest a potential reduction in stroke, larger trials are needed to establish the significance of these results.