AI Article Synopsis
- Cerebral embolic protection devices (CEPDs) help prevent debris from causing strokes during transcatheter aortic valve replacement (TAVR), especially in patients with a common variant of the aortic arch called bovine aortic arch (BAA).
- A study involving 165 adults showed that Sentinel CEPD insertion was feasible and safe, with an overall successful insertion rate of 86.6% and debris capture in 95% of cases, without any major complications or intraprocedural strokes.
- The findings suggest that operators can effectively use CEPDs in patients with BAA when they are familiar with the anatomy and techniques required for successful deployment.
Article Abstract
Background: Cerebral embolic protection devices (CEPDs) have emerged as a mechanical barrier to prevent debris from reaching the cerebral vasculature, potentially reducing stroke incidence. Bovine aortic arch (BAA) is the most common arch variant and represents challenge anatomy for CEPD insertion during transcatheter aortic valve replacement (TAVR).
Methods: Cohort study reporting the Sentinel Cerebral Protection System insertion's feasibility and safety in 165 adult patients submitted to a transfemoral TAVR procedure from April 2019 to April 2020. Patients were divided into 2 groups: (1) BAA; (2) non-BAA.
Results: Median age, EuroScore II, and STS score were 79 years (74-84), 2.9% (1.7-6.2), and 2.2% (1.6-3.2), respectively. BAA was present in 12% of cases. Successful two-filter insertion was 86.6% (89% non-BAA vs. 65% BAA; = 0.002), and debris was captured in 95% (94% non-BAA vs. 95% BAA; = 0.594). No procedural or vascular complications associated with Sentinel insertion and no intraprocedural strokes were reported. There were two postprocedural non-disabling strokes, both in non-BAA.
Conclusion: This study demonstrated Sentinel insertion feasibility and safety in BAA. No procedural and access complications related to Sentinel deployment were reported. Being aware of the bovine arch prevalence and having the techniques to navigate through it allows operators to successfully use CEPDs in this anatomy.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766100 | PMC |
| http://dx.doi.org/10.3390/jcm9124118 | DOI Listing |
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