Does the TriGUARD 3 cerebral embolic protection device reduce total cerebral ischemic lesion volume on DW-MRI in Chinese patients undergoing transfemoral TAVR for severe aortic stenosis?
The TriGUARD 3 cerebral embolic protection device did not significantly reduce total cerebral ischemic lesion volume on DW-MRI during TAVR overall, though exploratory findings suggest potential benefit in patients with bicuspid aortic valves.
Introduction: In China, evidence regarding cerebral embolic protection device (CEPD) use during transcatheter aortic valve replacement (TAVR) for severe aortic stenosis treatment is limited. This study evaluated the TriGUARD 3 (TG3) CEPD performance in patients undergoing TAVR. Methods: Data from two studies were pooled: the CEPD group was derived from a multicenter TG3 trial in China, whereas the control group was obtained from a single-center registry. All participants underwent transfemoral TAVR and completed pre- and postoperative diffusion-weighted magnetic resonance imaging (DW-MRI). The primary outcome was total cerebral ischemic lesion volume on DW-MRI. Results: < 0.05), independent of age, sex, hypertension, diabetes, valve type, and pre-dilatation. Conclusion: In patients with severe aortic stenosis undergoing transfemoral TAVR, TG3 CEPD did not significantly reduce the total lesion volume on DW-MRI. In the BAV subgroup, an association was observed between device use and reductions in total, average, and maximum single-lesion volumes. This exploratory finding is hypothesis-generating and should be further elucidated in larger randomized studies.
Li et al. (Wed,) studied this question.