Related Experiment Video
Updated: May 23, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Stroke complicating transcatheter aortic valve implantation: incidence, risk factors and outcome
Ronen R Leker1, Roni Eichel, Ami Verber
1Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. leker@hadassah.org.il
Insights
Transcatheter aortic valve implantation (TAVI) can lead to stroke, but most patients experience good outcomes. No specific risk factors predict stroke after TAVI, necessitating further research for identification.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Interventional Cardiology
Background:
- Transcatheter aortic valve implantation (TAVI) is a key treatment for high-risk patients needing aortic valve replacement.
- TAVI procedures carry an inherent risk of periprocedural stroke.
Purpose of the Study:
- To investigate the incidence and outcomes of periprocedural stroke following TAVI.
- To identify potential risk factors associated with stroke in TAVI patients.
Main Methods:
- A prospective database of consecutive patients undergoing TAVI with the Medtronic-Corevalve system was analyzed.
- Strokes and transient ischemic attacks within five days post-procedure were documented and compared to patients without neurological events.
Main Results:
- Eight out of 72 patients (11%) experienced neurological deficits (3 TIAs, 5 strokes).
- No significant differences in baseline or procedural variables were found between patients with and without stroke.
- Most strokes were attributed to embolic events from valve calcification; one TIA was due to bradycardia.
Conclusions:
- Periprocedural stroke after TAVI is relatively common but often associated with favorable outcomes.
- No specific pre-procedural or procedural risk factors were identified for stroke.
- Further research is needed to identify patients at higher risk for stroke post-TAVI.
Background:
Transcatheter aortic valve implantation is a novel therapeutic option for patients at high risk for surgical heart valve replacement that carries a risk for periprocedural stroke.
Patients And Methods:
Consecutive patients undergoing transcatheter aortic valve implantation with the self-expandable Medtronic-Corevalve Revalving system were included in a single-centre prospective database. Strokes complicating transcatheter aortic valve implantation in the first five-days following the procedure were documented, and the differences between patients with and without stroke were studied.
Results:
Seventy-two patients (32 men, mean age 80·5 ± 6·2) underwent transcatheter aortic valve implantation from September 2008 to April 2011. Of these, eight (11%) had focal neurological deficits in the periprocedural period (three transient ischaemic attacks, five strokes of which three were minor, one moderate, and one major). Patients with stroke/transient ischaemic attacks did not differ from those without cerebral ischaemia in baseline criteria or procedural variables. Six of the events were believed to be embolic resulting from dislodgement of calcific material from the aortic valve, and one transient ischaemic attack was secondary to hypoperfusion during severe bradycardia. One patient with basilar occlusion died, but the remaining six patients survived and all had a modified Rankin score ≤2 at 90 days. None of the patients had a recurrent stroke during follow-up.
Discussion:
Periprocedural cerebral ischaemia following transcatheter aortic valve implantation is not uncommon, but most patients have good outcomes. There was no particular pre-transcatheter aortic valve implantation or procedural risk factor profile that increased the risk for periprocedural stroke. Further studies are warranted to examine whether patients that are at higher risk for developing stroke after transcatheter aortic valve implantation can be identified.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:15Aortic Regurgitation I: Introduction