经导管主动脉瓣置换术相关脑卒中及脑栓塞保护装置的研究现状

Current research status of stroke and cerebral embolism protection devices in transcatheter aortic valve replacement

卒中为经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)的严重并发症之一,影响TAVR的预后,在导致患者生存率、生活质量下降的同时增加患者经济负担。近年来多种脑栓塞保护装置被用以减少TAVR相关卒中的发生率,改善预后,其中一些已经被批准用于临床。但其安全性、有效性存在诸多争议。该文回顾了TAVR相关卒中的定义、短期及长期发生率、危险因素,并对近期不同种脑栓塞保护装置的大型研究作出了详尽的阐述。

Stroke is one feared complication after transcatheter aortic valve replacement(TAVR).It affects the prognosis of TAVR,leading to a decline in the survival rate and quality of life of patients,while increasing the economic burden of patients.In recent years,a variety of cerebral embolic protection devices have been used to reduce the incidence of stroke during TAVR and improve the prognosis,some of which have been approved for clinical use.However,there are many controversies about their safety and effectiveness.This article reviews the definitions,short-term and long-term incidences,and risk factors of TAVR-related stroke,and elaborates on recent large-scale studies of different cerebral embolic protection devices.