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

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...

TAVR in Young Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has established itself as an effective strategy for the treatment of severe aortic stenosis across different risk groups. While previous...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...