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  1. The committee noted that there was no clinical evidence showing that having sodium zirconium cyclosilicate improved length or quality of life or allowed patients to stay on optimal doses of renin-angiotensin-aldosterone system (RAAS) inhibitors. It therefore considered that it would be valuable to have studies comparing sodium zirconium cyclosilicate plus standard care with standard care alone in people with confirmed hyperkalaemia of 6.0 mmol/litre and above, and that these should investigate: mortality disease progression patterns of RAAS inhibitor use healthcare utilisation, and health-related quality of life.

    Recommendation ID TA599/1 Question The committee noted that there was no clinical evidence showing that having sodium zirconium cyclosilicate

  2. The evidence on percutaneous insertion of a cerebral protection device to prevent cerebral embolism during TAVI raises no major safety concerns other than those associated with the TAVI procedure. However, the evidence on efficacy for preventing TAVI-related stroke is inconclusive. Therefore, this procedure should only be used with  special arrangements   for clinical governance, consent, and audit or research.

    Recommendation ID IPG650/1 Question The evidence on percutaneous insertion of a cerebral protection device to prevent cerebral embolism

  3. Current evidence on the safety of percutaneous mechanical thrombectomy for acute deep vein thrombosis (DVT) of the leg shows there are well-recognised but infrequent complications. For distal DVT that does not extend into the common femoral vein the evidence on efficacy is inconclusive, therefore this procedure should only be used in the context of  research .

    Recommendation ID IPG651/2 Question Current evidence on the safety of percutaneous mechanical thrombectomy for acute deep vein thrombosis

  4. The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh to prevent a parastomal hernia shows there are serious but well-recognised complications. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should not be used unless  special arrangements   are in place for clinical governance, consent, and audit or research.

    Recommendation ID IPG654/1 Question The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh

  5. NICE may update this guidance after 3 years or sooner if important new information becomes available, including evidence on: the epidemiology of CJD, including data on the prevalence of CJD and its infectivity in the UK population the transmission of CJD by surgical instruments, including cases of CJD in which surgery is a possible route of transmission the cost effectiveness of single-use instruments for use in interventional procedures on high-risk tissues commercially available decontmination methods that are safe and cost effective against prions the systems for, and cost effectiveness of, maintaining set integrity and traceability of instruments.

    Recommendation ID IPG666/1 Question NICE may update this guidance after 3 years or sooner if important new information becomes available