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Related Experiment Video

Updated: Jun 16, 2026

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Sentinel Cerebral Protection System in TAVI: An Updated Meta-Analysis of Randomized and Propensity-Matched Studies.

Márcio Braite1, Natanael de Paula Portilho2, Lara Barbosa de Souza Moura Canas Lara3

  • 1Hospital of Love, Barretos, São Paulo, Brazil.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 22, 2025
PubMed
Summary

The Sentinel cerebral embolic protection (CEP) system did not reduce stroke during transcatheter aortic valve implantation (TAVI). However, pooled analysis showed it lowered 30-day mortality and acute kidney injury (AKI).

Keywords:
cerebral embolic protection (CEP)meta‐analysistranscatheter aortic valve implantation (TAVI)

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Neurosurgery

Background:

  • Stroke is a significant complication following transcatheter aortic valve implantation (TAVI).
  • The Sentinel cerebral embolic protection (CEP) system aims to reduce embolic debris during TAVI.
  • The clinical effectiveness of the Sentinel CEP system in preventing stroke is not well-established.

Purpose of the Study:

  • To evaluate the impact of the Sentinel CEP system on stroke and related outcomes in patients undergoing TAVI.
  • To synthesize evidence from randomized controlled trials (RCTs) and propensity score-matched (PSM) studies.

Main Methods:

  • A systematic literature search was conducted across PubMed, Embase, and Cochrane databases.
  • Studies comparing TAVI with and without the Sentinel CEP system were included.
  • Pooled analysis using a random-effects model was performed to calculate risk ratios (RRs) and 95% confidence intervals (CIs) for various outcomes.

Main Results:

  • Eight studies (5 RCTs, 3 PSM) involving 33,111 patients were analyzed.
  • Sentinel CEP use was associated with significantly lower 30-day mortality (RR 0.75) and acute kidney injury (AKI) (RR 0.90).
  • No significant reduction was observed in periprocedural ischemic stroke, total stroke, in-hospital mortality, composite death or stroke, or major vascular complications.

Conclusions:

  • The Sentinel CEP system demonstrated a reduction in 30-day mortality and AKI in pooled analyses of TAVI patients.
  • The system did not significantly reduce stroke rates.
  • Further research is warranted, particularly in high-risk TAVI populations, given the lack of benefit observed in RCTs.