Agrawal Ankit, Isogai Toshiaki, Shekhar Shashank, Kapadia Samir
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland, OH.
US Cardiol. 2023 Mar 31;17:e02. doi: 10.15420/usc.2022.12. eCollection 2023.
Transcatheter aortic valve replacement (TAVR) has become a first-line treatment for severe aortic stenosis with intermediate to high-risk population with its use increasingly expanding into younger and low-risk cohorts as well. Cerebrovascular events are one of the most serious consequential complications of TAVR, which increase morbidity and mortality. The most probable origin of such neurological events is embolic in nature and the majority occur in the acute phase after TAVR when embolic events are most frequent. Cerebral embolic protection devices have been designed to capture or deflect these emboli, reducing the risk of peri-procedural ischaemic events. They also carry the potential to diminish the burden of new silent ischemic lesions during TAVR. Our review explores different types of these device systems, their rationale, and the established clinical data.
经导管主动脉瓣置换术（TAVR）已成为中高危人群严重主动脉瓣狭窄的一线治疗方法，其应用范围也日益扩大到年轻和低风险人群。脑血管事件是TAVR最严重的并发症之一，会增加发病率和死亡率。此类神经事件最可能的起源是栓塞性的，且大多数发生在TAVR后的急性期，此时栓塞事件最为频繁。脑栓塞保护装置旨在捕获或偏转这些栓子，降低围手术期缺血事件的风险。它们还有可能减轻TAVR期间新的无症状缺血性病变的负担。我们的综述探讨了这些装置系统的不同类型、其原理以及已有的临床数据。
