The incidence of stroke during TAVI up to 5 % (minimum ). Stroke risk reduction during TAVI is a critical requirement that can be a deterrent against this wonderful Intervention.
Many devices are being considered
- EmbolX (Edwards life science)
- Sentinel (Claret medical)
- TriGaurd (Keystone)
TriGaurd 3just got the approval from CE and appear promising. (REFLECT trial) It is inserted through the transfemoral route , deflects embolic material to descending aorta since it covers all the three branches of Arch.What happens to these deflected particles? Any bodys guess.
So , in my understanding it converts potential brain embolisation to peripheral microemboli , wh
A nice descriptive animation .https://player.vimeo.com/video/232995629
While, these innovative aortic arch filters reduce the risk of periprocedural embolic stroke, please mind, TAVR patients continue to be at significant risk for stroke over a long period. This is due to other late causes like TAVR leaflet thrombosis, atrial fibrillation, arch atheromas, and bleeding due antiplatelet agents.
1.WienekeVlastra, JeroenVendrik, Karel T.Koch et al Cerebral protection devices during transcatheter aortic valve implantation Trends in Cardiovascular Medicine Volume 28, Issue 6, August 2018, Pages 412-418