在过导管大动脉植入过程中进行常规的大脑栓塞保护
Rajesh K Kharbanda1,2,3, James Kennedy2, Zahra Jamal4
1Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, United Kingdom.
The New England journal of medicine
|March 31, 2025
概括
在跨导管大动脉植入 (TAVI) 期间常规使用脑栓塞保护 (CEP) 设备并没有减少中风的发生率. 这项随机试验在TAVI与CEP和TAVI单独之间没有发现中风率的显著差异.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 过导管大动脉植入 (TAVI) 与手术相关的中风有关.
- 大脑栓塞保护 (CEP) 设备旨在通过减少大脑栓塞来减轻这种风险.
研究的目的:
- 评估常规脑栓塞保护 (CEP) 设备在通过导管大动脉植入 (TAVI) 后减少中风发生率方面的有效性.
主要方法:
- 一个随机对照试验,涉及7635名参与者,在33个英国中心接受TAVI.
- 参与者被分配到具有CEP设备的TAVI或没有CEP设备的TAVI (控制).
- 主要结局是TAVI后72小时内或出院前发生的中风.
主要成果:
- 主要结局 (在72小时内中风) 的发生率在CEP组为2.1%,在对照组为2.2% (P=0.94).
- 失能性中风的发病率为CEP的1.2%,对照组为1.4%.
- 在两组之间,总体死亡率和访问部位并发症的发生率相似.
结论:
- 常规使用脑栓塞保护 (CEP) 装置不会显著降低中风的发生率在穿透导管大动脉植入 (TAVI) 后72小时内.
- 可能需要进一步的研究来确定在TAVI期间可能受益于CEP的特定患者子组.
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