Key result
Cerebral embolic protection devices during transcatheter aortic valve implantation show consistent safety and reduce silent brain lesions, but clear evidence for preventing clinical stroke is currently lacking.
Why the study?
Stroke remains a serious complication of TAVI, but the clinical evidence supporting the use of cerebral embolic protection devices is not yet clear.
Do cerebral embolic protection devices prevent stroke and silent brain lesions in patients undergoing transcatheter aortic valve implantation?
Do cerebral embolic protection devices prevent stroke and silent brain lesions in patients undergoing transcatheter aortic valve implantation?
While cerebral embolic protection devices effectively capture debris and may reduce silent ischemic lesions during TAVI, their impact on reducing clinically overt strokes remains unproven, highlighting the need for larger randomized trials.
Does not support routine use to prevent stroke; leaves open need for definitive RCTs.
Despite major advances in transcatheter aortic valve implantation (TAVI) technology during the last years, stroke remains one of the most serious complications of TAVI, tremendously increasing mortality and the loss of neurocognitive function. Since TAVI is expected to further spread into lower-risk patient groups, there will be greater emphasis to obviate such serious complications. One possible technique for preventing stroke is using cerebral embolic protection devices (CEPDs). CEPDs are designed for capturing or deflecting emboli that are en route to the brain and hence to protect the brain from embolism. Although their clinical utilization is increasing, the evidence for using CEPDs is not yet clear. Since this is a rapidly growing field with recent advances, and the impact of CEPD on preventing neurological events is still limited, there is an urgent need for understanding the role of CEPD in preventing clinically significant strokes. In this review, we present an overview of the available literature on CEPDs in patients undergoing TAVI and outline recent advances within this field.
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Richter et al. (2022) conducted a review in Aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Cerebral embolic protection devices (CEPDs) vs. Unprotected TAVI was evaluated. Cerebral embolic protection devices during transcatheter aortic valve implantation show consistent safety and reduce silent brain lesions, but clear evidence for preventing clinical stroke is currently lacking.
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