Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Implantation: An Updated Meta-Analysis of Randomized Controlled Trials Publisher Pubmed



Mansouri ES ; Queiroga F ; Ghasemi M ; Barbosa LM ; Pinilla J ; Faizan MA ; Ardebili SFZ ; Jena N ; Gomes W
Source: Indian Heart Journal Published:2025

Abstract

Background: Cerebral embolic protection devices (CEPD) have been designed to prevent embolization to the cerebral circulation during transcatheter aortic valve replacement (TAVR). However, the efficacy and safety of CEPD in stroke prevention in TAVR remains uncertain. Methods: PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) comparing CEPD vs. control for patients undergoing TAVR. Risk ratios (RR) with 95 % confidence intervals (CI) were pooled with a random-effects model. Results: Our meta-analysis included eight RCTs with 11,596 patients, of whom 5946 (51 %) were randomized to the CEPD group. There was no significant difference in the incidence of any stroke (3.51 % vs. 3.64 %; RR 0.91; 95 % CI 0.75–1.1; p = 0.33; I2 = 0 %) between groups. Similarly, CEPD did not significantly reduce the incidence of all-cause mortality (0.82 % vs. 0.67 %; RR 1.13; 95 % CI 0.74–1.74; p = 0.57; I2 = 0 %) Conclusions: Among patients undergoing TAVR, CEPD did not significantly reduce stroke incidence or all-cause mortality. © 2025 Elsevier B.V., All rights reserved.