Cerebral Embolic Protection Devices for Transcatheter Aortic Valve Replacement: Review of the Literature and Future Perspectives

Spencer Ng; Taylor Cunningham; John P Vavalle

doi:10.1007/s11886-024-02035-4

Cerebral Embolic Protection Devices for Transcatheter Aortic Valve Replacement: Review of the Literature and Future Perspectives

Curr Cardiol Rep. 2024 Mar 12. doi: 10.1007/s11886-024-02035-4. Online ahead of print.

Authors

Spencer Ng¹, Taylor Cunningham², John P Vavalle^{3

4

5}

Affiliations

¹ Division of Cardiology, University of North Carolina at Chapel Hill, 160 Dental Circle, Chapel Hill, NC, 27599-7075, USA.
² Campbell University School of Osteopathic Medicine, Lillington, NC, USA.
³ Division of Cardiology, University of North Carolina at Chapel Hill, 160 Dental Circle, Chapel Hill, NC, 27599-7075, USA. john_vavalle@med.unc.edu.
⁴ Structural Heart Disease Program, University of North Carolina at Chapel Hill, 160 Dental Circle, Chapel Hill, NC, 27599-7075, USA. john_vavalle@med.unc.edu.
⁵ School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7075, USA. john_vavalle@med.unc.edu.

PMID: 38472629
DOI: 10.1007/s11886-024-02035-4

Abstract

Purpose of review: Transcatheter aortic valve replacement (TAVR) has been a revolutionary therapy in the treatment of aortic valve stenosis. The risk of stroke associated with TAVR has decreased significantly since its introduction; however, it remains a devastating complication when it does occur.

Recent findings: Many of the strokes associated with TAVR occur peri-procedurally and are thought to be due to embolic debris entering the cerebrovascular circulation. A number of different cerebral embolic protection devices (CEPD) have been developed and are in various stages of testing and use. The results from clinical trials evaluating the role for CEPD to reduce the risk of stroke have been mixed. As a result, their uptake has been very heterogeneous. This review provides a summary of the diverse CEPD devices available for use and outlines the clinical evidence available to date.

Keywords: Aortic stenosis; Cerebral embolic protection; Stroke; TAVR.

Publication types

Review