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)
- Emrella
- 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.
Reference
Dr.S.Venkatesan MD 