Early Clinical Impact of Cerebral Embolic Protection in Patients Undergoing Transcatheter Aortic Valve Replacement ; A Two-Center Registry in the Netherlands

Background: We aimed to compare the rate of neurological events in patients with or without cerebral embolic protection (CEP) during transcatheter aortic valve replacement (TAVR). Methods and Results: Data on clinical end points including neurological events ≤30 days post-TAVR were collected for all patients who underwent transfemoral TAVR in 2 academic tertiary care institutions. Patients were matched through propensity scoring, which resulted in 333 pairs of patients with versus without CEP out of a total of 831 consecutive patients. The median age was 81 (76–85) years, and the median logist... Mehr ...

Verfasser: Kroon, Herbert G.
van der Werf, Hindrik W.
Hoeks, Sanne E.
van Gils, Lennart
van den Berge, Fauve R.
El Faquir, Nahid
Rahhab, Zouhair
Daemen, Joost
Poelman, Janny
Schurer, Remco A.J.
van den Heuvel, Ad
de Jaegere, Peter
van der Harst, Pim
Van Mieghem, Nicolas M.
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: Circulation: Cardiovascular Interventions ; volume 12, issue 6 ; ISSN 1941-7640 1941-7632
Verlag/Hrsg.: Ovid Technologies (Wolters Kluwer Health)
Schlagwörter: Cardiology and Cardiovascular Medicine
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27222180
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1161/circinterventions.118.007605

Background: We aimed to compare the rate of neurological events in patients with or without cerebral embolic protection (CEP) during transcatheter aortic valve replacement (TAVR). Methods and Results: Data on clinical end points including neurological events ≤30 days post-TAVR were collected for all patients who underwent transfemoral TAVR in 2 academic tertiary care institutions. Patients were matched through propensity scoring, which resulted in 333 pairs of patients with versus without CEP out of a total of 831 consecutive patients. The median age was 81 (76–85) years, and the median logistic EuroScore was 14% (9%–20%). The CEP group experienced less neurological events at 24 hours (1% versus 4%; P =0.035) and at 30 days (3% versus 7%; P =0.029). There were significantly more disabling strokes in unprotected patients at 30 days (1% versus 4%; P =0.039). CEP was associated with significantly fewer neurological events at 24 hours after TAVR (odds ratio, 0.20; 95% CI, 0.06–0.73; P =0.015) by multiple regression analysis, while age and valve type did not contribute significantly. Overall, 67% (2 of 3) in the CEP versus 83% (10 of 12) in the non-CEP cohort experienced neurological events in protected areas (ie, not dependent on the left vertebral artery). Conclusions: The use of filter-based CEP during TAVR was associated with less neurological events, especially in CEP-protected brain territories.