{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:02:30Z","timestamp":1784682150553,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Backgrounds<\/jats:title>\n                    <jats:p>Stroke remains a serious complication of transcatheter aortic valve implantation (TAVI). The Sentinel cerebral embolic protection (CEP) system is designed to mitigate this risk by capturing embolic debris, but its clinical benefit remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This meta\u2010analysis evaluated the impact of Sentinel CEP on stroke and related outcomes in TAVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Cochrane were searched for randomized controlled trials (RCTs) and propensity score\u2010matched (PSM) studies comparing TAVI with and without Sentinel CEP. The outcomes were periprocedural ischemic stroke, total stroke, disabling stroke, 30\u2010day mortality, in\u2010hospital mortality, composite death or stroke, acute kidney injury (AKI), and major vascular complications. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies (five RCTs, three PSM studies) encompassing 33,111 patients were analyzed, with 50.1% receiving Sentinel. In pooled analysis, Sentinel CEP significantly reduced 30\u2010day mortality (RR 0.75, 95% CI 0.58\u20130.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and AKI (RR 0.90, 95% CI 0.82\u20130.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). No significant effect was observed for periprocedural ischemic stroke (RR 0.92, CI 0.79\u20131.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.28), total stroke (RR 0.79, CI 0.59\u20131.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10), in\u2010hospital mortality (RR 0.86, CI 0.57\u20131.31;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.47), composite death or stroke, or major vascular complications. RCT\u2010only analyses confirmed no significant effect on any outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sentinel CEP was associated with lower 30\u2010day mortality and AKI in pooled cohorts, but did not reduce stroke. The absence of benefit in RCTs underscores the need for further studies in high\u2010risk TAVI populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70236","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:44:27Z","timestamp":1761111867000},"page":"3919-3927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sentinel Cerebral Protection System in TAVI: An Updated Meta\u2010Analysis of Randomized and Propensity\u2010Matched Studies"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7866-8436","authenticated-orcid":false,"given":"M\u00e1rcio","family":"Braite","sequence":"first","affiliation":[{"name":"Hospital of Love Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4402-9108","authenticated-orcid":false,"given":"Natanael de Paula","family":"Portilho","sequence":"additional","affiliation":[{"name":"Federal District Military Firefighter Brigade Brasilia Distrito Federal Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Barbosa de Souza Moura Canas","family":"Lara","sequence":"additional","affiliation":[{"name":"IDOMED\u2014Instituto de Educa\u00e7\u00e3o M\u00e9dica Rio de janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-2219","authenticated-orcid":false,"given":"Deivyd Vieira Silva","family":"Cavalcante","sequence":"additional","affiliation":[{"name":"University of North Texas Health Science Center Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo Crema","family":"Scheffer","sequence":"additional","affiliation":[{"name":"EMESCAM\u2014Escola Superior de Ci\u00eancias da Santa Casa de Miseric\u00f3rdia de Vit\u00f3ria Esp\u00edrito Santo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Ferreira","family":"Machado","sequence":"additional","affiliation":[{"name":"UNIFIPMOC\u2014Faculdades Integradas Pit\u00e1goras de Montes Claros  Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6544-8450","authenticated-orcid":false,"given":"Ivo Queiroz Costa","family":"Neto","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Wisconsin\u2014Madison Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline Rozaria Ferreira","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Military Police of Goias State Valparaiso de Goias Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8177-2269","authenticated-orcid":false,"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Padova 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