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Published on: June 3, 2018
Utility of Cerebral Embolic Protection in Non-TAVR Transcatheter Procedures
Mohammed Qintar1, Elian Abou Asala1, Tiberio Frisoli1
1Division of Cardiology, Henry Ford Health System, Detroit, MI, United States of America.
Insights
The Sentinel device is safe and effective for preventing stroke during non-transcatheter aortic valve replacement (TAVR) procedures. This cerebral protection device shows promise for high-risk patients undergoing various transcatheter interventions.
Area of Science:
- Cardiovascular Interventions
- Neurology
- Medical Device Technology
Background:
- Cerebrovascular events are a significant risk during structural and interventional procedures, leading to increased mortality.
- The Sentinel device is FDA-approved for transcatheter aortic valve replacement (TAVR).
- This study evaluates the Sentinel device's use in non-TAVR transcatheter procedures.
Purpose of the Study:
- To assess the safety and efficacy of the Sentinel device in patients undergoing non-TAVR transcatheter procedures.
- To report on the clinical experience with cerebral protection during these interventions.
Main Methods:
- Retrospective analysis of a single-center experience.
- Inclusion of 33 high-risk patients undergoing Sentinel device placement during non-TAVR procedures.
Main Results:
- Sentinel device placement was successful in all patients.
- No periprocedural strokes or vascular complications were observed.
- High-risk features included aortic arch atheroma, valve vegetations, and thrombi.
Conclusions:
- The Sentinel device is feasible and safe for non-TAVR indications.
- Further research is needed to establish the role and benefits of cerebral protection devices in non-TAVR interventions.
- Expanding use of cerebral protection is warranted with increasing non-TAVR procedures.
Background:
Cerebrovascular events that occur during structural and interventional procedures are a well known risk which is associated with increased mortality. The FDA has approved the use of the Sentinel device in TAVR. Hereby we report on our experience on the safety and efficacy of using Sentinel in a patient population undergoing non-TAVR transcatheter procedures.
Methods:
Retrospective analysis of a single center experience with using the Sentinel device for non-TAVR transcatheter procedures.
Results:
We identified 33 patients (average age was 73.8 years, 36.7% females, and 30% with history of a prior stroke) felt to be at high risk for cerebroembolic events that underwent Sentinel device placement. Sentinel placement was successful in all patients. Examples of high risk features included high atheroma burden in the aortic arch, left sided valve vegetations, intra-cardiac thrombi and severe left sided valve calcifications/thrombi. No patients developed periprocedural stroke or vascular complications.
Conclusion:
Overall, the use of Sentinel for non-TAVR indications appears feasible and safe. The use of cerebral protection devices should be studied further in non-TAVR patients to establish its role and its benefits, especially with expanding the number of non-TAVR transcatheter interventions.
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