TY  - JOUR
A1  - Seppelt, Philipp
A1  - Mas-Peiro, Silvia
A1  - De Rosa, Roberta
A1  - Dimitriasis, Zisis
A1  - Zeiher, Andreas M.
A1  - Vasa-Nicotera, Mariuca
T1  - 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
T2  - Clinical research in cardiology
N2  - 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.
KW  - Aortic stenosis
KW  - Stroke
KW  - Balloon-expandable TAVI
KW  - Self-expandable TAVI
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/79325
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-793256
SN  - 1861-0692
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 110
IS  - 5
SP  - 640
EP  - 648
PB  - Springer
CY  - Berlin
ER  -