Cerebrovascular events after transcatheter aortic valve implantation. [Review] - 2024

Periprocedural stroke after transcatheter aortic valve implantation (TAVI) remains a significant issue, which is associated with high morbidity, and is increasingly important as intervention shifts to younger and lower-risk populations. Over the last decade of clinical experience with TAVI, the incidence of periprocedural stroke has stayed largely unchanged, although it is prone to underreporting due to variation in ascertainment methods. The aetiology of stroke in TAVI patients is multifactorial, and changing risk profiles, differing study populations, and frequent device iterations have made it difficult to discern consistent risk factors. The objective of this review is to analyse and clarify the contemporary published literature on the epidemiology and mechanisms of neurological events in TAVI patients and evaluate potential preventive measures. This summary aims to improve patient risk assessment and refine case selection for cerebral embolic protection devices, while also providing a foundation for designing future trials focused on stroke prevention.


English

1774-024X

EIJ-D-23-01087 [pii] PMC11200663 [pmc]


*Aortic Valve Stenosis
*Stroke
*Transcatheter Aortic Valve Replacement
Aortic Valve Stenosis/su [Surgery]
Aortic Valve/su [Surgery]
Embolic Protection Devices
Humans
Incidence
Risk Assessment
Risk Factors
Stroke/et [Etiology]
Stroke/pc [Prevention & Control]
Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
Transcatheter Aortic Valve Replacement/is [Instrumentation]
Treatment Outcome--Automated


MedStar Heart & Vascular Institute
MedStar Washington Hospital Center


Advanced Cardiac Catheterization Research Fellowship


Journal Article
Review