经导管主动脉瓣置换术中单动脉入路脑栓塞保护的新方法
A Novel Approach for Cerebral Embolic Protection With Single-Artery Access in TAVR.
作者信息
George Isaac, Reisinger Maximilian, Kachel Mateusz, Gogorishvili Irakli, Dughashvili Gvantsa, Nour May, Nazif Tamim M
机构信息
Division of Cardiac, Thoracic, and Vascular Surgery, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York, USA; Structural Heart and Valve Center, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York, USA.
Division of Cardiac, Thoracic, and Vascular Surgery, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York, USA.
出版信息
JACC Case Rep. 2025 Jun 18;30(15):103768. doi: 10.1016/j.jaccas.2025.103768.
BACKGROUND
Cerebral embolic protection devices (CEPDs) have been developed to decrease embolic brain injury and stroke during transcatheter aortic valve replacement (TAVR). Simplifying vascular access for a CEPD may increase procedural efficiency and safety FIRST-IN-HUMAN/EARLY REPORTS SUMMARY: This is the first published report of the use of the novel EnCompass F filter, which consists of a cylindrical nitinol frame and electrospun filter. Complete cerebral embolic protection during TAVR is possible through single femoral arterial access.
DISCUSSION
Cerebral protection was feasible and safe without device-related complications, clinical stroke, or other neurologic events. Postprocedural diffusion-weighted magnetic resonance imaging revealed only 1 very small, clinically insignificant new brain lesion.
NOVELTY
This presents the first successful use of a CEPD in TAVR through access by a single femoral artery.
TAKE-HOME MESSAGE: The use of the novel EnCompass F filter was feasible to provide complete cerebral embolic protection in TAVR using a single access.
背景
已研发出脑栓塞保护装置（CEPD），以减少经导管主动脉瓣置换术（TAVR）期间的脑栓塞损伤和中风。简化CEPD的血管通路可能会提高手术效率和安全性。首例人体/早期报告总结：这是关于新型EnCompass F过滤器使用情况的首次发表报告，该过滤器由圆柱形镍钛诺框架和电纺过滤器组成。通过单股动脉通路在TAVR期间实现完全脑栓塞保护是可行的。
讨论
脑保护是可行且安全的，未出现与装置相关的并发症、临床中风或其他神经系统事件。术后扩散加权磁共振成像仅显示1个非常小的、临床上无显著意义的新脑损伤。
新颖之处
这是首次通过单股动脉通路成功在TAVR中使用CEPD。
要点
使用新型EnCompass F过滤器在TAVR中通过单一通路提供完全脑栓塞保护是可行的。
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