Key result
Cerebral embolic protection devices and optimized antithrombotic strategies are being investigated to mitigate the risk of periprocedural and long-term stroke in patients undergoing transcatheter aortic valve implantation.
Why the study?
Thromboembolic and hemorrhagic complications remain concerns in TAVI recipients and can be devastating, overshadowing the benefit achieved with TAVI.
This review provides a comprehensive overview of strategies to prevent stroke during and after TAVI, highlighting the evolving role of cerebral embolic protection devices and tailored antithrombotic regimens.
Stroke prevention in TAVI remains unresolved; leaves open optimal use of embolic protection and antithrombotic strategies pending randomized data.
Since its conception, transcatheter aortic valve implantation (TAVI) has undergone important improvements both in the implantation technique and in transcatheter devices, allowing an enthusiastic adoption of this therapeutic approach in a wide population of patients previously without a surgical option and managed conservatively. Nowadays, patients with severe symptomatic aortic stenosis are typically managed with TAVI, regardless of their risk to surgery, improving the prognosis of patients and thus achieving an exponential global expansion of its use. However, thromboembolic and hemorrhagic complications remain a latent concern in TAVI recipients. Both complications can appear simultaneously in the periprocedural period or during the follow-up, and when minor, they resolved without apparent sequelae, but in a relevant percentage of cases, they are devastating, overshadowing the benefit achieved with TAVI. Our review outlines the etiology and incidence of thromboembolic complications associated with TAVI, the main current strategies for their prevention, and the implications of its pharmacological management at the follow-up in a TAVI population, mostly frail and predisposed to bleeding complications.
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Díaz et al. (2022) conducted a review in Aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Cerebral embolic protection devices and antithrombotic therapy was evaluated. Cerebral embolic protection devices and optimized antithrombotic strategies are being investigated to mitigate the risk of periprocedural and long-term stroke in patients undergoing transcatheter aortic valve implantation.
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