Pedro G. Magalhaes1,2,3, MD; Nynke H. M. Kooistra4, MD, MSc; Geert E.H. Leenders2, MD, PhD; Pauliina M. Margolis5, MD, PhD; Alexandra J. Lansky6, MD, PhD; Adriaan O. Kraaijeveld2, MD, PhD; Michiel Voskuil2, MD, PhD; Pieter R. Stella2, MD, PhD
1. Department of Cardiology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Hospital of Vila Real, Vila Real, Portugal; 2. Department of Interventional Cardiology, Heart & Lungs Division, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands; 3. Sociedade Portuguesa de Cardiologia, Lisbon, Portugal; 4. Department of Cardiology, Heart & Lungs Division, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands; 5. Keystone Heart, Tampa, FL, USA; 6. Cardiovascular Medicine, Heart and Vascular Clinical Research Program, Yale University School of Medicine, New Haven, CT, USA
Introduction
A substantial proportion of patients submitted to transcatheter aortic valve replacement (TAVR) continues to be affected by procedure-related neurological events, with 30-day clinical stroke rates in the range of 4-7%. Also, routine neuroimaging studies reveal that ischaemic cerebral infarction caused by showers of cerebral emboli during valve instrumentation and placement affect virtually all patients undergoing TAVR1,2,3.
In order to prevent these embolic phenomena, several cerebral embolic protection devices (CEPD) have recently been developed. Their use during TAVR has been associated with improved early imaging and clinical neurological outcomes1.