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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Stroke Prevention: Let's Prepare for Generation X TAVR

Laura J Davidson1, Charles J Davidson2

  • 1Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 21, 2016
PubMed

Insights

Stroke after TAVR is a serious risk. Identifying patients with chronic kidney disease or prior stroke can help predict stroke risk. New strategies may reduce stroke and brain lesions after TAVR.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Nephrology

Background:

  • Stroke is a major complication following Transcatheter Aortic Valve Replacement (TAVR), leading to significant patient morbidity, disability, and mortality.
  • Chronic kidney disease (CKD) and a history of prior stroke are identified as key risk factors that increase the likelihood of stroke in the TAVR population.

Purpose of the Study:

  • To highlight the importance of stratifying stroke risk in patients undergoing TAVR.
  • To discuss the potential of emerging strategies in mitigating stroke risk and reducing new brain lesions post-TAVR.

Main Methods:

  • Review of existing literature and risk factors associated with post-TAVR stroke.
  • Analysis of ongoing prospective randomized trials investigating novel preventative measures.

Main Results:

  • CKD and prior stroke are significant predictors of stroke after TAVR.
  • Emerging interventions show promise in reducing stroke incidence and subclinical brain injury.

Conclusions:

  • Accurate stroke risk stratification is crucial for improving TAVR outcomes.
  • Embolic protection devices and post-implant anticoagulation strategies represent promising avenues for future stroke prevention in TAVR patients.

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