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经导管主动脉瓣植入术期间的发病率、危险因素及卒中预防

Incidence, Risk Factors, and Stroke Prevention During Transcatheter Aortic Valve Implantation.

作者信息

Misra Sannidhya, Khokhar Arif A, Lucarelli Carla, Khawaja Saud, Mikhail Ghada W

机构信息

Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, W12 0HS London, UK.

出版信息

Rev Cardiovasc Med. 2025 Apr 22;26(4):26867. doi: 10.31083/RCM26867. eCollection 2025 Apr.

Abstract

Stroke remains a significant, potentially life-threatening complication following transcatheter aortic valve implantation (TAVI). Moreover, the rate of strokes, particularly disabling strokes, has not diminished over time despite improvements in pre-procedural planning and implantation techniques. The mechanisms of stroke in TAVI patients are complex, and identifying consistent risk factors is challenging due to evolving patient profiles, varied study cohorts, and continuous device modifications. Multiple pharmacological and mechanical treatment strategies have been developed to mitigate the risk of stroke, particularly as TAVI expands toward younger populations. This review article discusses the pertinent factors in the evolution of stroke post-TAVI, appraises the latest evidence and techniques designed to reduce the risk of stroke, and highlights future strategies and technologies to address this unmet need.

摘要

中风仍然是经导管主动脉瓣植入术(TAVI)后一种严重的、可能危及生命的并发症。此外,尽管术前规划和植入技术有所改进,但随着时间的推移,中风发生率,尤其是致残性中风的发生率并未降低。TAVI患者中风的机制很复杂,由于患者特征不断变化、研究队列不同以及器械持续改进,确定一致的风险因素具有挑战性。已经开发了多种药物和机械治疗策略来降低中风风险,特别是随着TAVI向年轻人群扩展。这篇综述文章讨论了TAVI后中风演变中的相关因素,评估了旨在降低中风风险的最新证据和技术,并强调了满足这一未满足需求的未来策略和技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23d3/12059732/73c6f1d8891d/2153-8174-26-4-26867-g1.jpg

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