Valvular & structural heart disease

The Impact of Cerebral Embolic Protection Devices on Characteristics and Outcomes of Stroke Complicating Transcatheter Aortic Valve Replacement (TAVR)

JACC Cardiovasc IntervPublished Registry-based cohort study

Authors' conclusion

In a large cohort of patients with AISCT, the use of CEPD had little effect on stroke distribution, severity, and outcomes.

Study context

Population
Patients with acute ischemic stroke within 72 hours of TAVR (acute ischemic stroke complicating TAVR (AISCT))AISCT in 18,725 TAVR
Participants
416 patients
Exposure
Cerebral embolic protection devices (CEPD)-protected TAVR vs unprotected TAVR
  • CEPD-n = 376reference
  • CEPD+n = 40
Outcome
Disabling stroke (modified Rankin Score >1) at 30 days and 6-month all-cause death
Follow-up
30 days; 6 months
Methodological detailsinternational multicentre registry, propensity-score matched analysis
  • International multicentre registry
  • Propensity-score matched analysis

Main finding

As reported in the abstract

Disabling stroke at 30 days

P = 0.62

6-month mortality

P = 0.61

Observational data: associations, not effects.

Further findings

Disabling stroke and 6-month mortality, propensity-score matched cohort · matched cohort

Disabling stroke

P = 0.16

6-month mortality

P = 0.35

Middle cerebral artery stroke

P = 0.71

Internal carotid artery occlusion

Vertebrobasilar system strokes

P = 0.04

Severe stroke (NIHSS ≥15)

P = 0.20

Original publication

The Impact of Cerebral Embolic Protection Devices on Characteristics and Outcomes of Stroke Complicating TAVR. JACC Cardiovasc Interv. Published 11 March 2024. doi:10.1016/j.jcin.2023.12.033

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