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Cited by 325

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement

Open access
Kapadia, Samir R., Makkar, Raj, Leon, Martin, Abdel-Wahab, Mohamed, Waggoner, Thomas, Massberg, Steffen, Rottbauer, Wolfgang, Horr, Samuel, Sondergaard, Lars, Karha, Juhana, Gooley, Robert, Satler, Lowell, Stoler, Robert C., Messé, Steven R., Baron, Suzanne J., Seeger, Julia, Kodali, Susheel, Krishnaswamy, Amar, Thourani, Vinod H., Harrington, Katherine, Pocock, Stuart, Modolo, Rodrigo, Allocco, Dominic J., Meredith, Ian T., Linke, Axel·2022·New England Journal of Medicine

Abstract

BACKGROUND: Transcatheter aortic-valve replacement (TAVR) for the treatment of aortic stenosis can lead to embolization of debris. Capture of debris by devices that provide cerebral embolic protection (CEP) may reduce the risk of stroke. METHODS: We randomly assigned patients with aortic stenosis in a 1:1 ratio to undergo transfemoral TAVR with CEP (CEP group) or without CEP (control group). The primary end point was stroke within 72 hours after TAVR or before discharge (whichever came first) in the intention-to-treat population. Disabling stroke, death, transient ischemic attack, delirium, major or minor vascular complications at the CEP access site, and acute kidney injury were also assessed. A neurology professional examined all the patients at baseline and after TAVR. RESULTS: A total of 3000 patients across North America, Europe, and Australia underwent randomization; 1501 were assigned to the CEP group and 1499 to the control group. A CEP device was successfully deployed in 1406 of the 1489 patients (94.4%) in whom an attempt was made. The incidence of stroke within 72 hours after TAVR or before discharge did not differ significantly between the CEP group and the control group (2.3% vs. 2.9%; difference, -0.6 percentage points; 95% confidence interval, -1.7 to 0.5; P = 0.30). Disabling stroke occurred in 0.5% of the patients in the CEP group and in 1.3% of those in the control group. There were no substantial differences between the CEP group and the control group in the percentage of patients who died (0.5% vs. 0.3%); had a stroke, a transient ischemic attack, or delirium (3.1% vs. 3.7%); or had acute kidney injury (0.5% vs. 0.5%). One patient (0.1%) had a vascular complication at the CEP access site. CONCLUSIONS: Among patients with aortic stenosis undergoing transfemoral TAVR, the use of CEP did not have a significant effect on the incidence of periprocedural stroke, but on the basis of the 95% confidence interval around this outcome, the results may not rule out a benefit of CEP during TAVR. (Funded by Boston Scientific; PROTECTED TAVR ClinicalTrials.gov number, NCT04149535.).

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Metadata

Authors
Kapadia, S. R., Makkar, R., Leon, M., Abdel-Wahab, M., Waggoner, T., Massberg, S., Rottbauer, W., Horr, S., Sondergaard, L., Karha, J., Gooley, R., Satler, L., Stoler, R. C., Messé, S. R., Baron, S. J., Seeger, J., Kodali, S., Krishnaswamy, A., Thourani, V. H., Harrington, K., Pocock, S., Modolo, R., Allocco, D. J., Meredith, I. T., & Linke, A.
Venue
New England Journal of Medicine
Published
2022-10-06
Volume
387
Issue
14
Pages
1253-1263
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W4296143892
Cited by
325
References
30
FWCI
38.29
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement. https://app.cochat.ai/papers/10.1056/nejmoa2204961
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Kapadia, S. R., Makkar, R., Leon, M., Abdel-Wahab, M., Waggoner, T., Massberg, S., Rottbauer, W., Horr, S., Sondergaard, L., Karha, J., Gooley, R., Satler, L., Stoler, R. C., Messé, S. R., Baron, S. J., Seeger, J., Kodali, S., Krishnaswamy, A., Thourani, V. H., . . . Linke, A. (2022). Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2204961

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.