2026 American Academy of Neurology Abstract Website

Rowaid Ahmad¹, Hassan Waseem², Zain ul Abideen³, Muhammad Osama⁴, Muhammad Haseeb Khan³, Rabeya Farid⁵, Nohela Rehman⁶, Muhammad Ansari⁵, Muhammad Ansari¹, Justin Chen⁷, Jamir Pitton Rissardo⁸, Ana Leticia Fornari Caprara⁸, Vishnu Byroju⁹, Adam Dmytriw¹⁰, Brandon Lucke-Wold¹¹
¹UTMB, ²Allama Iqbal Medical College, ³King Edward Medical University, ⁴Hayatabad Medical Complex, ⁵Jinnah Sindh Medical University, ⁶Dow University of Health Sciences, ⁷Texas A&M College of Medicine, ⁸Cooper University Hospital, ⁹Cooper University Healthcare, ¹⁰Massachusetts General Hospital, ¹¹University of Florida

Objective:

This meta-analysis evaluated the effectiveness and safety of cerebral embolic protection devices (CEPDs) in patients undergoing transcatheter aortic valve implantation (TAVI).

Background:

Transcatheter aortic valve implantation (TAVI) is now a widely accepted treatment for patients with severe aortic stenosis. It offers a less invasive alternative to surgical aortic valve replacement (SAVR) with faster recovery and better early quality of life. However, stroke is still a major complication that can happen during or after the procedure.

Design/Methods:

PubMed, Cochrane Central, and ScienceDirect were searched till April 2025. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled under a random-effects model using Review Manager version 5.4.1. The Cochrane risk of bias (RoB 2.0) tool was used for quality assessment. Funnel plots were assessed for publication bias.

Results:

Eight randomized controlled trials, including 11,632 patients undergoing TAVI, were analyzed. The use of CEPDs showed a non-significant reduction in all strokes (RR 0.92, 95% CI: 0.74–1.15, p = 0.48) and disabling strokes (RR 0.80, 95% CI: 0.57–1.12, p = 0.18). There was no significant difference in all-cause mortality (RR 1.09, 95% CI: 0.71–1.67, p=0.70), disabling bleeding (RR 0.96, 95% CI: 0.28-3.31; p=0.94), and major vascular complications (RR 1.25, 95% CI: 0.56-2.78, p=0.59).

Conclusions:

CEPD did not lead to significant changes in the rates of all strokes, disabling strokes, all-cause mortality, disabling bleeding, or major vascular complications. Current evidence does not support a statistically significant clinical benefit of CEPD use during TAVI. Although trends indicate a possible reduction in stroke, larger trials are necessary to confirm the significance of these findings.