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Invited Commentary
February 24, 2020

Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Replacement—Effective in Stroke Prevention?

Author Affiliations
  • 1Division of Cardiology, University of Texas Southwestern Medical Center, Dallas
  • 2Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa and Comprehensive Access and Delivery Research & Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City
JAMA Intern Med. 2020;180(5):785-786. doi:10.1001/jamainternmed.2019.6763

Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for severe symptomatic aortic stenosis. Despite advances in device technology and procedural techniques, periprocedural stroke remains a severe complication of TAVR, affecting 2% of patients.1 The embolization of calcific debris from the degenerated aortic valve and atherosclerotic plaque from the aorta, both of which are manipulated during TAVR, is the likely mechanism of periprocedural stroke. Accordingly, cerebral embolic protection devices (EPDs) have been designed to prevent stroke by sequestering embolic debris during TAVR.1

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