Vlastra Wieneke, Vendrik Jeroen, Koch Karel T, Baan Jan, Piek Jan J, Delewi Ronak
Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Trends Cardiovasc Med. 2018 Aug;28(6):412-418. doi: 10.1016/j.tcm.2018.01.007. Epub 2018 Feb 2.
Transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis is associated with an improvement of clinical outcomes, quality of life, and self-sufficiency. The most feared TAVI-related complication is the occurrence of stroke. In order to reduce peri-procedural cerebral embolizations, diverse cerebral protection devices have been developed. These devices work though deflection or filtering of emboli, and are in different stages of testing. Silent cerebral infarctions identified by diffusion-weighted magnetic resonance imaging (DW-MRI) are used as surrogate primary outcomes, but the clinical significance is still unclear. This review provides a synopsis of the diverse cerebral protection devices and summarizes the current evidence on their efficacy during TAVI.
经导管主动脉瓣植入术（TAVI）用于治疗主动脉瓣狭窄患者，可改善临床结局、生活质量和自理能力。TAVI最可怕的相关并发症是中风。为减少围手术期脑栓塞的发生，已研发出多种脑保护装置。这些装置通过使栓子偏折或过滤来发挥作用，且处于不同的测试阶段。通过扩散加权磁共振成像（DW-MRI）识别的无症状脑梗死被用作替代主要结局，但临床意义仍不明确。本综述概述了多种脑保护装置，并总结了目前关于其在TAVI期间疗效的证据。
