Insights on Embolic Protection, Repositioning, and Stroke: A Subanalysis of the RESPOND Study

Journal of Interventional Cardiology
Julia SeegerNicolas M Van Mieghem

Abstract

RESPOND is a prospective, single-arm study enrolling 1014 transcatheter aortic valve replacement (TAVR) patients. The objective of this analysis is to assess the impact of cerebral embolic protection (CEP) devices and prosthetic valve repositioning on the risk of neurologic complications in patients treated with the fully repositionable Lotus Valve in the RESPOND postmarket study. Valve repositioning and CEP use were at the operators' discretion. Stroke events were adjudicated by an independent medical reviewer. This analysis assessed the baseline differences among patients according to CEP use and valve repositioning and evaluated the neurological complications at 72 hours after TAVR, hospital discharge, and 30-day follow-up. A multivariate analysis was performed to identify the potential predictors of stroke. Of the 996 patients implanted with the Lotus Valve (mean age: 80.8 years, 50.8% female, STS score 6.0 ± 6.9), 92 cases (9.2%) used CEP. The overall rate of acute stroke/transient ischemic attack (TIA) was 3.0% at 72 hours after TAVR. The 72-hour stroke/TIA rate was 1.1% in patients who had CEP and 3.2% in those who did not. Use of CEP was associated with a 2.1% absolute reduction in the risk of acute neurological events ...Continue Reading

References

Dec 28, 2010·Journal of the American College of Cardiology·Josep Rodés-CabauJohn G Webb
Mar 10, 2012·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Christoph K NaberEberhard Grube
Sep 3, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Robert GooleyIan T Meredith
Jul 21, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Nicolas M Van MieghemPeter P T de Jaegere
Sep 21, 2016·The American Journal of Cardiology·Alexandra J LanskyJohn K Forrest
Nov 7, 2016·Journal of the American College of Cardiology·Samir R KapadiaUNKNOWN SENTINEL Trial Investigators
Apr 16, 2017·Stroke; a Journal of Cerebral Circulation·Rodrigo BagurMamas A Mamas
May 31, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Ian T MeredithKeith D Dawkins

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Clinical Trials Mentioned

NCT04149535

Software Mentioned

SAS
RESPOND
Lotus

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