Evidence map›Paper›PMID 40347211›Full record

SynthesisCardiovascular intervention and therapeutics2025

Cerebral embolic protection in transcatheter aortic valve implantation (TAVI): a pooled analysis of 4091 patients.

Mahmoud Balata, Mohamed Ibrahim Gbreel, Mohamed Hamouda Elkasaby, Ahmed Samy Badran, Marwa Hassan, Ralf Westenfeld, Roman Pfister, Sebastian Zimmer, Marc Ulrich Becher, Georg Nickenig and 1 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular intervention and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mahmoud BalataDepartment of Internal Medicine and Cardiology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany. dr.mahmoud.balata@gmail.com.
Mohamed Ibrahim GbreelFaculty of Medicine, October 6 University, Giza, Egypt.
Mohamed Hamouda ElkasabyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Samy BadranFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Marwa HassanDepartment of Immunology, Theodor Bilharz Research Institute, Giza, Egypt.
Ralf WestenfeldDepartment of Internal Medicine and Cardiology, University Hospital Duesseldorf, Düsseldorf, Germany.
Roman PfisterDepartment of Internal Medicine and Cardiology, University Hospital Cologne, Cologne, Germany.
Sebastian ZimmerDepartment of Internal Medicine and Polyclinic II, University Hospital Bonn, Bonn, Germany.
Marc Ulrich BecherDepartment of Internal Medicine and Cardiology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Georg NickenigDepartment of Internal Medicine and Polyclinic II, University Hospital Bonn, Bonn, Germany.
Atsushi SugiuraDepartment of Internal Medicine and Polyclinic II, University Hospital Bonn, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranscatheter aortic valve implantation (TAVI) is increasingly used for severe aortic stenosis, but debris embolization during the procedure can lead to strokes, impacting survival and quality of life. The role of cerebral embolic protection devices (CEPDs) in mitigating stroke risk remains debated. We aim to evaluate the impact of CEPDs on the risk of stroke and neurocognitive outcomes after TAVI.

methodsSix databases (PubMed, Scopus, Web of Science, Cochrane, Embase, and Ovid) were searched until 20 January 2023. Original randomized controlled trials (RCTs) were only included and critically appraised using the Cochrane risk of bias (ROB) tool.

resultsSeven RCTs (4091 patients) were analyzed. CEPDs significantly reduced the risk of disabling stroke within 2-5 days post-TAVI (relative risk = 0.455, 95% CI: [0.214, 0.967]; p = 0.041). However, there was no significant difference in disabling stroke risk between the two groups at the 30-day follow-up (relative risk = 1.295, 95% CI: [0.373, 4.493]; p = 0.684). No significant differences were observed in non-disabling or overall stroke rates at 2-5 days, 30 days, or 90 days. Additionally, CEPDs did not significantly affect risks of life-threatening bleeding, major vascular complications, mortality, or acute kidney injury.

conclusionCEPDs are effective in reducing disabling stroke risk in the immediate post-TAVI period (2-5 days) but did not significantly affect the rates of non-disabling stroke, overall stroke, or disabling stroke after 30 days when compared to non-CEPD use. These findings suggest that CEPDs may offer short-term neuroprotection.

Indexed as

Aortic Valve StenosisEmbolic Protection DevicesIntracranial EmbolismStrokeTranscatheter Aortic Valve ReplacementHumansRandomized Controlled Trials as TopicCerebral embolic protectionMeta-analysisNeurological complicationsSystematic reviewTranscatheter valve implantation

Identifiers

PMID40347211

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.