{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:07:08Z","timestamp":1780988828054,"version":"3.54.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008977","name":"Universit\u00e4t Ulm","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008977","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Cerebral embolic protection (CEP) reduces strokes during transcatheter aortic valve replacement (TAVR) but is not standard of care at most centers.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To assess the impact of CEP use in real-world practice at a tertiary center using CEP as a standard of care during TAVR.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In-hospital outcome of 2173 patients was compared to 328 (13.1%) patients who could not receive CEP during TAVR due to anatomical or technical reasons. In a secondary analysis, adjusted stroke risk was compared using propensity score matching.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Non-CEP patients had significantly higher Society of Thoracic Surgeons score for mortality (5.2 [interquartile range (IQR): 3.3\u20137.9] vs. 3.4% [IQR: 2.2\u20135.9],\n p<\/jats:italic>\n \u2009<\u20090.01) and were more often female (54.0 vs. 46.4%,\n p<\/jats:italic>\n \u2009=\u20090.01). Comorbidities such as coronary artery disease (63.4 vs. 61.7%,\n p<\/jats:italic>\n \u2009=\u20090.54) and prior cardiac surgery (11.9 vs. 9.6%,\n p<\/jats:italic>\n \u2009=\u20090.19) were equally frequent in both groups, whereas a history of prior stroke (16.2 vs. 11.7%,\n p<\/jats:italic>\n \u2009=\u20090.02) was more frequent in non-CEP patients. Despite significantly longer procedure time in CEP patients (55.0 min [IQR: 46.0\u201366.0] vs. 53.0 min [43.0\u201363.3],\n p<\/jats:italic>\n \u2009<\u20090.01), intraprocedural death (0 vs. 0.1%,\n p<\/jats:italic>\n \u2009=\u20091.0), arrhythmia (11.9 vs. 11.9%,\n p<\/jats:italic>\n \u2009=\u20090.99), and vascular access-site complications (5.5 vs. 4.3%,\n p<\/jats:italic>\n \u2009=\u20090.32) were equally frequent. Although intraprocedural stroke occurred seldomly in both patient groups (0 vs. 0.3%,\n p<\/jats:italic>\n \u2009=\u20091.0), in-hospital disabling stroke occurred more often in non-CEP patients (4.0 vs. 1.8%,\n p<\/jats:italic>\n \u2009=\u20090.01). In the propensity score matched cohort, CEP use was associated with a significantly lower risk of all stroke (OR: 0.41, 95% CI: 0.22\u20130.77,\n p<\/jats:italic>\n \u2009<\u20090.01) as well as disabling stroke (OR: 0.37, 95% CI: 0.18\u20130.78,\n p<\/jats:italic>\n \u2009<\u20090.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n At a high-volume center using CEP as part of its standard of care during TAVR, CEP use was associated with a lower rate of in-hospital stroke. Especially those patients who could not receive CEP seemed to be at increased risk for stroke.<\/jats:p>\n <\/jats:sec>\n \n Graphical Abstract<\/jats:title>\n Two thousand five hundred one patients were analyzed according to CEP use. CEP could be used in the majority of patients, whereas a minority (13.1%) of patients could not receive CEP for technical or anatomical reasons. Non-CEP patients had significantly higher procedural risk and experienced in-hospital stroke more often.<\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00392-025-02802-5","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T09:23:30Z","timestamp":1763976210000},"page":"1218-1229","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cerebral embolic protection (CEP) during transcatheter aortic valve replacement (TAVR) is associated with a lower rate of stroke at a high-volume center"],"prefix":"10.1007","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-3908","authenticated-orcid":false,"given":"Michael","family":"Paukovitsch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lorenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Felbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinny","family":"Scheffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin","family":"Krohn-Grimberghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonhard Moritz","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"M\u00f6rike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Rottbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Buckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"2802_CR1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.032901","volume":"13","author":"AC van Nieuwkerk","year":"2024","unstructured":"van Nieuwkerk AC, Aarts HM, Hemelrijk KI et al (2024) Cerebrovascular events in patients undergoing transfemoral transcatheter aortic valve implantation: a pooled patient-level study. 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