EuroPCR 2018 | SENTINEL: Anatomical Predictors of Stroke during TAVR

The rate of cerebrovascular events in TAVR hovers about 4% in most of the current studies, regardless the center, the operator or the prosthetic valve. At present, no scores can adequately predict which patients run the highest risk of stroke during TAVR, and the routine use of cerebral protection devices remains controversial.

The SENTINEL study randomized 347 patients 2:1 to embolic protection devices during TAVR vs. a control group with no protection. All anatomical data ─valve, aorta and extra cranial vessels─ were collected and analyzed.

 

Anatomical variations such as type of arch, root angulation and amount of calcium, can increase the chance of stroke. However, device benefits were consistent across subgroups.


Read also: EuroPCR 2018 | NOTION: Good TAVR Durability Compared with Surgically-Implanted Valve in Low-Risk Patients.


Paradoxically, the greatest events reduction using cerebral protection devices was observed in patients with lower calcium burden. This might be due to the more friable nature of perivalvular tissue at higher risk of embolization.

 

This information confirms the unpredictable nature of periprocedural stroke and supports the routine use of cerebro-embolic protection devices until more, larger, studies come along.

 

Original title: Anatomical predictors of stroke prevention during transcatheter aortic valve implantation – The SENTINEL Trial.

Presenter: Hasan Jilaihawi.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....