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脑栓塞保护装置:经导管主动脉瓣置换术有哪些适应证?

Cerebral Embolic Protection Devices: Are There Any Indications in Transcatheter Aortic Valve Replacement?

作者信息

Sayah Neila, Skalidis Ioannis, Mesnier Jules, Neylon Antoinette, Akodad Mariama, Asgar Anita

机构信息

Institut Cardiovasculaire Paris-Sud, Hôpital Jacques Cartier, Ramsay-Santé, 91300 Massy, France.

Department of Cardiology, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland.

出版信息

J Clin Med. 2024 Sep 14;13(18):5471. doi: 10.3390/jcm13185471.

Abstract

Stroke following transcatheter aortic valve replacement (TAVR) is a significant and life-threatening adverse event. The vast majority of these incidents occur during the TAVR procedure or within the first 24 h following TAVR, with a notable prevalence of cerebral embolic events. In response to this concern, cerebral embolic protection devices (CEPDs) have been designed to mitigate the risk of peri-procedural ischemic stroke during TAVR. The primary objective of CEPDs is to diminish the intraprocedural burden associated with new silent ischemic brain injuries. Despite the development of several CEPDs, their clinical efficacy remains uncertain. In this review, we delve into a comprehensive analysis of the utilization of CEPDs in patients undergoing TAVR, exploring insights from the existing literature. Additionally, we aim to present future perspectives and discuss the clinical implications associated with the incorporation of CEPDs in TAVR procedures.

摘要

经导管主动脉瓣置换术(TAVR)后发生的中风是一种严重且危及生命的不良事件。这些事件绝大多数发生在TAVR手术期间或TAVR后的头24小时内,脑栓塞事件的发生率显著。针对这一问题,人们设计了脑栓塞保护装置(CEPD),以降低TAVR期间围手术期缺血性中风的风险。CEPD的主要目标是减轻与新的无症状缺血性脑损伤相关的手术负担。尽管已经开发了几种CEPD,但其临床疗效仍不确定。在这篇综述中,我们深入全面地分析了CEPD在接受TAVR治疗的患者中的应用情况,探讨现有文献中的见解。此外,我们旨在提出未来的观点,并讨论在TAVR手术中使用CEPD的临床意义。

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本文引用的文献

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Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement.经导管主动脉瓣置换术中的脑栓塞保护
Struct Heart. 2023 Apr 17;7(4):100169. doi: 10.1016/j.shj.2023.100169. eCollection 2023 Jul.

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