Hossam El Benawi: Do Current Generation CEPD Devices Reduce the Risk of any Stroke During TAVR?
Hossam El Benawi, Senior Clinical Research Fellow of Cardiovascular Medicine at Mayo Clinic, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in American Heart Journal, adding:
“Current generation CEPD devices during TAVR did not significantly reduce the risk of any stroke, disabling stroke, or all-cause mortality.
Our analysis, Studies included: 8 RCTs (5 filter-based, 3 shield-based), totaling 11,597 patients:
- Any stroke: No reduction with CEPD (RR 0.92; 95% CI 0.75–1.14)
- Disabling stroke: No significant difference (RR 0.80; 95% CI 0.55–1.15)
- MRI-detected lesions: No effect (RR 1.00; 95% CI 0.93–1.07)
- All-cause mortality: No significant difference (RR 1.04; 95% CI 0.71–1.51)
- Trial sequential analysis: Demonstrated conclusive evidence, supporting no benefit of Current generation CEPD.
- Meta-regression: No significant association between stroke risk and patient-level factors (age, sex, diabetes, prior stroke, atrial fibrillation; all p > 0.05)
At least with available data, cumulative evidence appears sufficient to question the predefined benefit thresholds for existing systems.
These findings suggest the lack of routine use of current-generation CEPD in TAVR.”
Title: Cerebral Embolic Protection Devices for Transcatheter Aortic Valve Replacement: A Meta-Analysis and Trial Sequential Analysis
Authors: Hossam Elbenawi, Ibrahim Hassan, Mahmoud Shaaban Abdelgalil, Mariam Hanna, Salma Almotawally, Mahmoud Fayed, Kareem A. Mohamed, Hossam Elnaggar, Louna Abouainain, Belal Mohamed Hamed, Ahmed Ibrahim, Ahmed Al Khatib, Mohamed Elhelw, Ehab Hassan, Mahmoud Eisa, Morad Zaaya, Ramzi Ibrahim, Andrew M. Goldsweig, Marwan Saad, Fernando Alfonso, Mohamad Alkhouli, Islam Y. Elgendy
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