{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:38:46Z","timestamp":1787060326750,"version":"build-2736575974"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Sentinel cerebral embolic protection device (CEP) aims to reduce the risk of stroke during transcatheter aortic valve replacement (TAVR). We performed a systematic review and meta-analysis of propensity score matched (PSM) and randomized controlled trials (RCT) investigating the effect of the Sentinel CEP to prevent strokes during TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible trials were searched through PubMed, ISI Web of science databases, Cochrane database, and proceedings of major congresses. Primary outcome was stroke. Secondary outcomes included all-cause mortality, major or life-threatening bleeding, major vascular complications and acute kidney injury at discharge. Fixed and random effect models were used to calculate the pooled risk ratio (RR) with 95% confidence intervals (CI) and absolute risk difference (ARD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 4066 patients from 4 RCTs (3\u2032506 patients) and 1 PSM study (560 patients) were included. Use of Sentinel CEP was successful in 92% of patients and was associated with a significantly lower risk of stroke (RR: 0.67, 95% CI: 0.48\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02. ARD: -1.3%, 95% CI: -2.3 \u2013 -0.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02, number needed to treat (NNT)\u2009=\u200977), and a reduced risk of disabling stroke (RR: 0.33, 95% CI: 0.17\u20130.65. ARD: -0.9%, 95% CI: -1.5 \u2013 -0.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004, NNT\u2009=\u2009111). Use of Sentinel CEP was associated with a lower risk of major or life-threatening bleeding (RR: 0.37, 95% CI: 0.16\u20130.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Risk for nondisabling stroke (RR: 0.93, 95% CI: 0.62\u20131.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.73), all-cause mortality (RR: 0.70, 95% CI: 0.35\u20131.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.31), major vascular complications (RR: 0.74, 95% CI: 0.33\u20131.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.47) and acute kidney injury (RR: 0.74, 95% CI: 0.37\u20131.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.40) were similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of CEP during TAVR was associated with lower risks of any stroke and disabling stroke with an NNT of 77 and 111, respectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-023-03338-0","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T03:01:33Z","timestamp":1686970893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Cerebral embolic protection during transcatheter aortic valve replacement: a systematic review and meta-analysis of propensity score matched and randomized controlled trials using the Sentinel cerebral embolic protection device"],"prefix":"10.1186","volume":"23","author":[{"given":"Mathias","family":"Wolfrum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immanuel Justus","family":"Handerer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Moccetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schmeisser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruediger C.","family":"Braun-Dullaeus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Toggweiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,17]]},"reference":[{"issue":"19","key":"3338_CR1","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.1056\/NEJMoa1400590","volume":"370","author":"DH Adams","year":"2014","unstructured":"Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, Gleason TG, Buchbinder M, Hermiller J Jr, Kleiman NS, et al. 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MW is a proctor for New Valve Technology \/ Biosensors. The other authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"306"}}