Efficacy of Sentinel Cerebral Embolic Protection Device in Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies.

Autor:	Jain H; From the Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India., Pervez N; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Dey D; Department of Internal Medicine, Medical College and Hospital, Kolkata, India., Odat RM; Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan., Jain J; From the Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India., Goyal A; Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India., Saggar A; Department of Internal Medicine, Punjab Institute of Medical Sciences, Jalandhar, India., Hussein AM; Department of Internal Medicine, Faculty of Medicine, Al-Balqa' Applied University, Salt, Jordan., Mathur A; Department of Internal Medicine, Jhalawar Hospital and Medical College, Jhalawar, Rajasthan, India., Khanna S; Department of Internal Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India., Ahmed R; Department of Cardiology, National Heart and Lung Institute, Imperial College London, London, United Kingdom., Shahid F; Department of Interventional Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Jazyk:	angličtina
Zdroj:	Cardiology in review [Cardiol Rev] 2024 Sep 30. Date of Electronic Publication: 2024 Sep 30.
DOI:	10.1097/CRD.0000000000000797
Abstrakt:	Transcatheter aortic valve replacement (TAVR) is frequently associated with stroke due to debris embolization. Although the risk of stroke with newer-generation devices is lower, stroke still represents a significant cause of mortality and morbidity post-TAVR. The Sentinel cerebral embolic protection device (CEPD) is a dual-embolic filter device designed to capture debris dislodged during TAVR. A systematic literature search was performed on the major bibliographic databases to retrieve studies that compared TAVR with and without Sentinel CEPD. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the DerSimonian-Laird random-effects model, with a P value of <0.05 considered statistically significant. This meta-analysis included 6 studies with 25,130 patients undergoing TAVR (12,608: Sentinel CEPD; 12,522: without Sentinel CEPD). The use of the Sentinel CEPD in TAVR was associated with a statistically significant lower risk of acute kidney injury (OR: 0.89; 95% CI: 0.81-0.97; P = 0.01]. The use of Sentinel CEPD in TAVR was associated with a statistically insignificant trend toward a reduction in stroke (OR: 0.80; 95% CI: 0.58-1.10; P = 0.18), all-cause mortality (OR: 0.74; 95% CI: 0.51-1.07; P = 0.11), and major vascular complications (OR: 0.74; 95% CI: 0.46-1.19; P = 0.21). The use of Sentinel CEPD in patients undergoing TAVR does not lead to a statistically significant reduction in stroke, all-cause mortality, or major vascular complications; however, the risk of acute kidney injury is lower. Further randomized studies are warranted to confirm these findings. Competing Interests: Disclosure: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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