Cerebral embolic protection devices for transcatheter aortic valve replacement: A meta-analysis and trial sequential analysis.
Hossam Elbenawi, Ibrahim Hassan, Mahmoud Shaaban Abdelgalil et al.
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In 30 seconds
This meta-analysis evaluated the efficacy of current-generation cerebral embolic protection devices (CEPDs) during transcatheter aortic valve replacement (TAVR) across 8 randomized controlled trials involving 11,596 patients. The analysis found no significant reduction in the incidence of any stroke (RR 0.92; 95% CI 0.75-1.14), disabling stroke (RR 0.80; 95% CI 0.55-1.15), or all-cause mortality (RR 1.04; 95% CI 0.71-1.51).
Key findings
- CEPD use did not significantly reduce any stroke incidence (RR 0.92; 95% CI 0.75-1.14).
- No significant reduction in disabling stroke was observed (RR 0.80; 95% CI 0.55-1.15).
- All-cause mortality was not significantly affected by CEPD use (RR 1.04; 95% CI 0.71-1.51).
- Trial sequential analysis confirmed the absence of benefit from CEPDs in TAVR.
Why it matters
The findings challenge the routine use of cerebral embolic protection devices during TAVR, suggesting that their implementation may not provide the anticipated benefits in reducing stroke risk or mortality, which is crucial for clinical decision-making.