{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:36:13Z","timestamp":1786977373656,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"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":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Stroke remains one of the most devastating complications following transcatheter aortic valve implantation (TAVI). Although cerebral embolic protection devices (CEPDs) have emerged to mitigate patients' risks, their impact on stroke risk, as well as other clinical and neurocognitive outcomes after TAVI, remains uncertain. We aimed to assess whether CEPDs alleviate stroke risks and neurocognitive outcomes after TAVI. We systematically searched MEDLINE, Scopus, Web of Science (WOS), and the Cochrane CENTRAL from inception until May 2025. We included randomized controlled trials (RCTs) that assessed the effectiveness of CEPD compared to the control group (no CEPD) in adult patients (&gt;\u200918 years) undergoing TAVI. The primary endpoint was the incidence of all\u2010cause stroke. In contrast, the secondary endpoints included disabling stroke, systemic bleeding, transient ischemic attack (TIA), and major adverse cardiovascular and cerebrovascular events (MACCE). Additionally, we assessed neurological outcomes, including changes in the Montreal Cognitive Assessment (MoCA) score, the National Institutes of Health Stroke Scale (NIHSS) score, and the presence of new ischemic lesions. Nine RCTs comprising 11,696 patients were included in the final analysis. The use of CEPDs showed no statistical difference in reducing all\u2010cause stroke compared to the control group (OR\u2009=\u20090.91, 95% CI [0.73\u20131.15],\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.44). Additionally, there was no significant difference in other studies' secondary outcomes, including disabling stroke, MACCE, systemic bleeding, or neurological outcomes, such as worsening NISSS, decline in MoCA score, and the presence of new ischemic lesions. The use of CEPD during TAVI showed no benefit in reducing the risks of all\u2010cause stroke and other neurological outcomes studied.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70411","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T05:42:32Z","timestamp":1765345352000},"page":"795-806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cerebral Embolic Protection Devices for the Prevention of Stroke in Patients Undergoing Transcatheter Aortic Valve Implantation: An Updated Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9474-324X","authenticated-orcid":false,"given":"Ahmed","family":"Nazmy","sequence":"first","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Kafr\u2010Elsheikh University Kafr\u2010Elsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Sobhy","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Kafr\u2010Elsheikh University Kafr\u2010Elsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0042-6101","authenticated-orcid":false,"given":"Ahmed","family":"Elshahat","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Al\u2010Azhar University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Division of Cardiology Montefiore Health System\/Albert Einstein College of Medicine, Montefiore Medical Center Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebtsam","family":"Makhlouf","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Department of Cardiology, Faculty of Medicine Minia University Minia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira Fahmy","family":"El\u2010Nemr","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Al\u2010Azhar University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Sabri","family":"Hassanin","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Al\u2010Azhar University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Atta","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Institute of Medicine National Research Mordovia State University Saransk Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2695-5665","authenticated-orcid":false,"given":"Ahmed Yasser","family":"Shaban","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Department of Hematology and Oncology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Nazmy","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Faculty of Medicine Kafr\u2010Elsheikh University Kafr\u2010Elsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh K.","family":"Kharbanda","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Oxford University Hospitals NHS Foundation Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-6196","authenticated-orcid":false,"given":"Basel","family":"Abdelazeem","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy Arlington Massachusetts USA"},{"name":"Department of Cardiology West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":false,"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences Keele 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