Thirty-day incidence of stroke after transfemoral transcatheter aortic valve implantation: meta-analysis and mixt-treatment comparison of self-expandable versus balloon-expandable valve prostheses
- Aims: Stroke is a major complication after transcatheter aortic valve implantation (TAVI). Although multifactorial, it remains unknown whether the valve deployment system itself has an impact on the incidence of early stroke. We performed a meta- and network analysis to investigate the 30-day stroke incidence of self-expandable (SEV) and balloon-expandable (BEV) valves after transfemoral TAVI. Methods and results: Overall, 2723 articles were searched directly comparing the performance of SEV and BEV after transfemoral TAVI, from which 9 were included (3086 patients). Random effects models were used for meta- and network meta-analysis based on a frequentist framework. Thirty-day incidence of stroke was 1.8% in SEV and 3.1% in BEV (risk ratio of 0.62, 95% confidence interval (CI) 0.49–0.80, p = 0.004). Treatment ranking based on network analysis (P-score) revealed CoreValve with the best performance for 30-day stroke incidence (75.2%), whereas SAPIEN had the worst (19.0%). However, network analysis showed no inferiority of SAPIEN compared with CoreValve (odds ratio 2.24, 95% CI 0.70–7.2). Conclusion: Our analysis indicates higher 30-day stroke incidence after transfemoral TAVI with BEV compared to SEV. We could not find evidence for superiority of a specific valve system. More randomized controlled trials with head-to-head comparison of SEV and BEV are needed to address this open question.
Verfasserangaben: | Philipp SeppeltORCiDGND, Silvia Mas-PeiroORCiDGND, Roberta De RosaORCiD, Zisis Dimitriasis, Andreas M. ZeiherORCiDGND, Mariuca Vasa-NicoteraORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-793256 |
DOI: | https://doi.org/10.1007/s00392-020-01775-x |
ISSN: | 1861-0692 |
Titel des übergeordneten Werkes (Englisch): | Clinical research in cardiology |
Verlag: | Springer |
Verlagsort: | Berlin |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 29.11.2020 |
Datum der Erstveröffentlichung: | 29.11.2020 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 07.11.2023 |
Freies Schlagwort / Tag: | Aortic stenosis; Balloon-expandable TAVI; Self-expandable TAVI; Stroke |
Jahrgang: | 110 |
Ausgabe / Heft: | 5 |
Seitenzahl: | 9 |
Erste Seite: | 640 |
Letzte Seite: | 648 |
Bemerkung: | Open Access funding enabled and organized by Projekt DEAL. |
Institute: | Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | Creative Commons - CC BY - Namensnennung 4.0 International |