在跨导管大动脉置换中进行脑栓塞保护
Mina Iskander1,2, Yasser Jamil1, John K Forrest1
1Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
Structural heart : the journal of the Heart Team
|July 31, 2023
概括
透管大动脉置换 (TAVR) 正在扩大到低风险患者. 脑栓塞保护装置旨在降低中风风险,这是TAVR手术期间的一个主要问题.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 神经外科 神经外科
背景情况:
- 过导管大动脉置换 (TAVR) 是严重的大动脉狭窄的主要治疗方法.
- 现在TAVR适用于所有手术风险类别的患者.
- 脑卒中是TAVR之后的一个重大并发症,通常被认为比死亡更糟糕.
研究的目的:
- 审查TAVR之后的中风机制和预测因素.
- 描述大脑栓塞保护装置 (CEPD) 及其临床证据.
- 为CEPD在TAVR中的使用提供建议.
主要方法:
- 关于TAVR相关中风的当前文献的综述.
- 现有脑栓塞保护装置的描述,它们的设计和临床数据.
- 分析正在进行的随机对照试验,评估TAVR期间CEPD.
主要成果:
- 尽管TAVR取得了进展,中风仍然是令人担忧的并发症.
- 有各种CEPD存在,随着临床数据的不断变化.
- 在TAVR中常规使用CEPD的证据仍在发展.
结论:
- 了解中风机制对于预防至关重要.
- 大脑栓塞保护装置在TAVR期间减轻中风风险方面显示出有前途.
- 进一步的研究和正在进行的试验将澄清CEPD在TAVR中的作用.
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