Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Kardiol Pol. 2022;80(6):644-650. doi: 10.33963/KP.a2022.0118. Epub 2022 May 6.
Despite major advances in transcatheter aortic valve implantation (TAVI) technology during the last years, stroke remains one of the most serious complications of TAVI, tremendously increasing mortality and the loss of neurocognitive function. Since TAVI is expected to further spread into lower-risk patient groups, there will be greater emphasis to obviate such serious complications. One possible technique for preventing stroke is using cerebral embolic protection devices (CEPDs). CEPDs are designed for capturing or deflecting emboli that are en route to the brain and hence to protect the brain from embolism. Although their clinical utilization is increasing, the evidence for using CEPDs is not yet clear. Since this is a rapidly growing field with recent advances, and the impact of CEPD on preventing neurological events is still limited, there is an urgent need for understanding the role of CEPD in preventing clinically significant strokes. In this review, we present an overview of the available literature on CEPDs in patients undergoing TAVI and outline recent advances within this field.
尽管近年来经导管主动脉瓣植入术（TAVI）技术取得了重大进展，但卒中仍然是 TAVI 最严重的并发症之一，极大地增加了死亡率和神经认知功能丧失的风险。由于 TAVI 预计将进一步扩展到低风险患者群体，因此将更加重视避免此类严重并发症。预防卒中的一种可能技术是使用脑保护装置（CEPD）。CEPD 的设计目的是捕获或偏转即将进入大脑的栓子，从而保护大脑免受栓塞。尽管它们的临床应用正在增加，但使用 CEPD 的证据尚不清楚。由于这是一个快速发展的领域，并且 CEPD 对预防神经事件的影响仍然有限，因此迫切需要了解 CEPD 在预防临床上有意义的卒中方面的作用。在这篇综述中，我们介绍了 TAVI 患者中 CEPD 的现有文献概述，并概述了该领域的最新进展。
