HealthDay News – For patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), use of a cerebral protection device is associated with a reduction in the frequency of ischemic cerebral lesions, according to a study published in the August 9 issue of the Journal of the American Medical Association.

Stephan Haussig, MD, from the University of Leipzig in Germany, and colleagues examined the effect of a cerebral protection device on the number and volume of cerebral lesions in patients undergoing TAVI in a single-center randomized trial. 

Patients with severe aortic stenosis undergoing TAVI underwent brain MRI at baseline and 2 and 7 days after TAVI. One hundred patients were randomized in a 1:1 ratio to TAVI with a cerebral protection device (filter group) or without a cerebral protection device (control).


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Researchers found that the primary end point of the number of new lesions was lower in the filter vs the control group (4.00 vs 10.00; P<.001). There was also a lower new lesion volume after TAVI in the filter group compared to the control group (527 vs 242 mm³; P=.001).

“Larger studies are needed to assess the effect of cerebral protection device use on neurological and cognitive function after TAVI and to devise methods that will provide more complete coverage of the brain to prevent new lesions,” the authors wrote.

Disclosures: Several authors disclosed financial ties to pharmaceutical and medical device companies, including Claret Medical and Medtronic, which funded the study.

References

  1. Haussig S, Mangner N, Dwyer MG, et al. Effect of a cerebral protection device on brain lesions following transcatheter arotic valve implantation in patients with severe aortic stenosis. The CLEAN-TAVI randomized clinical trial. JAMA. 2016;316(6):592-601. doi: 10.1001/jama.2016.10302.
  2. Messe SR, Mack MJ. Improving outcomes from transcatheter aortic valve implantation. Protecting the brain from the heart. JAMA. 2016;316(6):587-588. doi: 10.1001/jama.2016.10316.