Cerebral embolic protection in Transcather Aortic Valve Replacement: An updated meta-analysis of 11692 patients AHA Conference Repository

American Heart Association

Final ID: 4365473

Cerebral embolic protection in Transcather Aortic Valve Replacement: An updated meta-analysis of 11692 patients

Abstract Body (Do not enter title and authors here):
Background: We conducted an updated meta-analysis of the routine use of cerebral embolic
protection (CEP) devices in Transcathter Aortic Valve Replacement (TAVR). This analysis
follows the recent BHF PROTECTED TAVI trial which is the largest randomized controlled
trial to date.

Methods: Electronic databases were searched through April 2025 for eligible randomized
controlled trials (RCTs). The primary outcome was overall incidence of stroke, disabling
stroke and non-disabling stroke all reported at 2-5 days and 30 days were primary outcomes
for our analyses.

Results: 8 RCTs with a total of 11,692 patients were included. No statistically significant
difference was found between CEP group and the control group in overall stroke incidence at
2-5 days and 30 days as the following (RR=0.95, 95%CI: [0.75,1.19], p=0.64) and (RR=0.93,
95%CI: [0.57,1.53], p=0.79). Similarly, the pooled analysis revealed no statistically
significant difference between the two groups in terms of disabling stroke at 2-5 days
(RR=0.70, 95%CI: [0.41,1.18], p=0.18), and at 30 days (RR=1.18, 95%CI: [0.36,3.87],
p=0.78). CEP group and control group didn’t show statistically significant difference in non-
disabling stroke at 2-5 days and 30 days as the results showed: (RR=1.17, 95%CI:
[0.84,1.63], p=0.36) and (RR=0.86, 95%CI: [0.49,1.51], P=0.61) respectively.

Conclusion: Our meta-analysis found no statistically significant evidence that cerebral
embolic protection (CEP) devices reduce the incidence of stroke—disabling or non-disabling
in the 2-5 days following TAVR or after 30 days. Major bleeding, major vascular
complication and AKI showed no statistically significant results indicating a neutral safety
profile.

Kholeif, Zeyad ( Mayo Clinic, MN , Rochester , Minnesota , United States )
Mohamed, Ahmed ( Faculty of Medicine, Tanta University , Tanta , Egypt )
Elnady, Mohamed ( Faculty of medicine Kafer El Sheikh , Kafer el sheikh , Egypt )
Alomari, Amal ( Faculty of Medicine, Yarmouk University , Irbid , Jordan )
Rashwan, Rana ( Mayo Clinic , Rochester , Minnesota , United States )
Samman Tahhan, Imad ( Medical University of South Carolin , Charleston , South Carolina , United States )
Elnashar, Mohab ( UAMS , Little Rock , Arkansas , United States )
Khalafallah, Mohamed ( Faculty of Medicine, Alexandria University , Alexandria , Egypt )
Afify, Raneem ( Faculty of Medicine, Tanta University , Tanta , Egypt )
Gadelmawla, Ahmed Farid ( Faculty of Medicine, Menoufia Unive , Menoufia , Egypt )
Elkasaby, Hamza ( Faculty of Medicine, Newgize University , Cairo , Egypt )
Elalfy, Aya ( Mayo Clinic , Jacksonville , Florida , United States )
Barsoom, Ramez ( Mayo Clinic , Jacksonville , Florida , United States )
Hemida, Mohamed Fawzi ( Alexandria Faculty of Medicine , Alexandria , Egypt )
Ali, Ahmed ( Crestwood Medical Centre , Jacksonville , Alabama , United States )
Kietselaer, Bastiaan ( Mayo Clinic , Rochester , Minnesota , United States )

Author Disclosures:

Zeyad Kholeif: