预期中风在接受过导管大动脉置换的患者中
Joseph Hajj1, Ziad Zalaquett1, Serge Harb1
1Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Expert review of medical devices
|January 22, 2026
概括
过导管大动脉置换 (TAVR) 可以导致中风,这是一个严重的并发症. 虽然脑栓塞保护装置 (CEPD) 显示出一些前景,但个性化抗血栓治疗目前是TAVR患者中风预防的关键.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 干预心脏病学 干预心脏病学
背景情况:
- 过导管大动脉置换 (TAVR) 是严重的大动脉狭窄的不那么侵入性治疗方法.
- 脑卒中是TAVR后的重大并发症,影响患者的结果和认知功能.
- 有效的中风预防策略对于改善TAVR患者护理至关重要.
研究的目的:
- 审查TAVR后中风的机制和危险因素.
- 评估当前的预防策略,包括脑栓塞保护装置 (CEPD) 和抗血栓治疗.
- 提供有关这些策略在TAVR中的作用的专家意见.
主要方法:
- 对PubMed的有针对性的文献评论.
- 对脑栓塞保护装置 (例如,哨兵系统) 的研究分析.
- 对抗血栓策略的审查 (TAVR前,内和后).
主要成果:
- 在随机试验中,证据表明CEPD可以减少中风并未得到一致的证实.
- 对于CEPD的高成本限制了它们的常规采用.
- 在老年TAVR患者中,平衡血栓塞栓保护和出血风险至关重要.
结论:
- 在TAVR中,个性化抗血栓治疗对于预防中风至关重要.
- 可以考虑选择性使用CEPD,特别是在高风险子组中.
- 需要进一步研究设备的改进和CEPD的大规模试验.
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