ArticleCirculation. Cardiovascular interventions2024
Impact of Cerebral Embolic Protection Devices on Disabling Stroke After TAVR: Updated Results From the STS/ACC TVT Registry.
Article in Circulation. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Efficacy of Cerebral Embolic Protection Device in Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Pooled it
- Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Implantation: Meta-Analysis With Trial Sequential Analysis.Journal of the American Heart Association · 2025Pooled it
- Cerebral embolic protection devices in transcatheter aortic valve implantation: An updated meta-analysis of randomized controlled trials.Indian heart journalPooled it
- Contemporary Management of Aortic Stenosis: Timing of Intervention and Lifetime Valve Management.European journal of clinical investigation · 2026Review
- Cerebrovascular Events in Aortic Stenosis: From Native Valve Disease to TAVR-Specific Risk and Prevention.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Review
- Cerebral embolic protection (CEP) during transcatheter aortic valve replacement (TAVR) is associated with a lower rate of stroke at a high-volume center.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Stroke Rates and Clinical Outcomes After Transcaval Transcatheter Aortic Valve Replacement With and Without Central Embolic Protection: A Single-Center Experience.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Machine Learning-Enhanced TCAB Score for Predicting Postoperative Ischemic Stroke After CABG.Journal of the American Heart Association · 2026Article
- Right Atrial Thrombus After Aspiration Thrombectomy for Pulmonary Embolism: Oh No or PFO?JACC. Case reports · 2026Article
- A Left Atrial-to-Femoral Arterial Bypass Percutaneous Ventricular Assist Device as a Bridge to Transcatheter Aortic Valve Replacement.JACC. Case reports · 2026Article
- Review
- The Utility of Cerebral Protection Devices in Transcatheter Aortic Valve Replacement: A Systematic Review and Bayesian Meta-analysis.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Review
- Expected Surgical Risk and the Risk of Stroke and Brain Injury After Transcatheter Aortic Valve Replacement: A Patient-Level Pooled Analysis.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Cerebral Embolic Protection Device Use, Stroke, and Disabling Stroke in TAVR Before and After PROTECTED-TAVR.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Sex Differences in Stroke Frequency and Severity Following Transcatheter Aortic Valve Replacement.Journal of the American Heart Association · 2025Article
- Preventing cerebrovascular events in patients undergoing TAVR: the current and future landscape.Future cardiology · 2025Article
- Neuroprotection Devices in Cardiac Catheterization Laboratories: Does It Sufficiently Protect Our Patients?Medicina (Kaunas, Lithuania) · 2025Review
- Prediction of stroke in patients with severe aortic stenosis by left atrial appendage filling defect patterns on early and late-phase computed tomography.International journal of cardiology. Heart & vasculature · 2025Article
- Management of Acute Ischemic Stroke Following Transcatheter Aortic Valve Implantation: A Systematic Review and Multidisciplinary Treatment Recommendations.Journal of clinical medicine · 2024Review
- 2024 Update on Cerebral Embolic Protection After Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2024Review
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9 authors.
Funding
Abstract
backgroundCerebral embolic protection devices (EPDs) were developed to mitigate the risk of stroke during transcatheter aortic valve replacement (TAVR), but their benefit remains unproven. In the PROTECTED-TAVR trial (Stroke Protection With Sentinel During Transcatheter), EPD use did not reduce periprocedural stroke (primary study outcome) but led to a 62% reduction in the secondary end point of disabling stroke. Given these results, the impact of EPDs during TAVR remains unclear.
methodsWe used STS/ACC TVT registry data to examine the association between EPD use and a proxy for disabling stroke among transfemoral TAVR patients between January 2018 and June 2023. The primary outcome was in-hospital disabling stroke-defined as stroke associated with either in-hospital death or discharge to a nonhome location. We evaluated the association between EPD use and disabling stroke using instrumental variable analysis with a site-level preference for EPD use as the instrument-a quasi-experimental approach that can support causal inference. In addition, we performed a propensity score-based comparison using overlap weighting as a secondary analysis.
resultsThe study population consisted of 414 649 patients of whom 53 389 (12.9%) received an EPD. The unadjusted rate of in-hospital disabling stroke was 0.7% among the EPD group and 0.9% in the no-EPD group. EPD use was associated with a reduction in disabling stroke in both instrumental variable analysis (relative risk, 0.87 [95% CI, 0.73-1.00]) and propensity-weighted analysis (odds ratio, 0.79 [95% CI, 0.70-0.90]) but was not associated with a reduction in nondisabling stroke. In subgroup analyses, the benefit of EPD was greater among those with versus without prior stroke (
conclusionsIn the largest study to date, among patients undergoing TAVR, EPD use was associated with a small, borderline significant reduction in stroke associated with death or discharge to a nonhome location (a proxy for disabling stroke) that is likely to be causal in nature. Taken together with previous mechanistic and clinical studies, these findings provide credible evidence that EPDs benefit patients undergoing TAVR.
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