Incidence, Risk Factors, and Stroke Prevention During Transcatheter Aortic Valve Implantation.

Abstract

Stroke remains a significant, potentially life-threatening complication following transcatheter aortic valve implantation (TAVI). Moreover, the rate of strokes, particularly disabling strokes, has not diminished over time despite improvements in pre-procedural planning and implantation techniques. The mechanisms of stroke in TAVI patients are complex, and identifying consistent risk factors is challenging due to evolving patient profiles, varied study cohorts, and continuous device modifications. Multiple pharmacological and mechanical treatment strategies have been developed to mitigate the risk of stroke, particularly as TAVI expands toward younger populations. This review article discusses the pertinent factors in the evolution of stroke post-TAVI, appraises the latest evidence and techniques designed to reduce the risk of stroke, and highlights future strategies and technologies to address this unmet need.