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Updated: Feb 21, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Cerebral protection during transcatheter aortic valve implantation in an extreme high-risk patient
Stephanie Voss1, Christian Nöbauer1, Rüdiger Lange1
1Department of Cardiovascular Surgery, German Heart Center Munich, Clinic at the Technical University, Munich, Germany.
Insights
Cerebral protection devices during transcatheter aortic valve replacement may prevent stroke. A dual filter device captured debris, and the patient experienced no post-procedure neurological deficits.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Stroke is a significant complication of transcatheter aortic valve replacement (TAVR).
- Cerebral embolization of debris during TAVR poses a risk for cerebrovascular accidents.
- Advanced technologies are emerging to mitigate embolic events during TAVR.
Observation:
- A high-risk 78-year-old patient with severe calcific aortic stenosis underwent TAVR.
- The patient was protected using the dual filter-based Claret Sentinel™ Cerebral Protection Device.
- The Sentinel Device was observed to capture macroscopic debris during the procedure.
Findings:
- The Claret Sentinel Device successfully captured embolic material during TAVR.
- Post-procedure neurological assessment revealed no deficits using the National Institutes of Health Stroke Scale and modified Rankin scale.
- This suggests the device's efficacy in preventing stroke during TAVR.
Implications:
- Cerebral protection devices may reduce the incidence of stroke in TAVR patients.
- The Sentinel Device offers a potential strategy for preventing neurological complications in high-risk TAVR candidates.
- Further research should explore the widespread adoption and long-term benefits of cerebral protection during TAVR.
Abstract:
Stroke during transcatheter aortic valve replacement is one of the most feared complications. New technologies have been developed, attempting to prevent cerebral embolization of thrombotic and calcific debris. We report a 78-year-old patient (EuroSCORE log 45.6%, STS Stroke Score 5.1%) with calcific aortic stenosis at particular risk for cerebrovascular accidents. The patient underwent transapical transcatheter aortic valve replacement using the dual filter-based Claret Sentinel™ Device for cerebral protection. Claret Sentinel Device use was associated with capture of macroscopic debris. Postoperatively, no neurological deficits could be detected by the National Institutes of Health Stroke Scale and modified Rankin scale.
