title: What can be done for cerebral embolic protection in TAVI? Analysis in the light of 10 years' experience with protected carotid artery stenting.
abstract: In the last 30 years, development of minimally invasive percutaneous procedures to treat cardiovascular defects has been thriving. Although these techniques present obvious advantages, like avoiding cardiopulmonary bypass, the passage of catheter systems and the deployment of devices in the blood circulation can cause particle embolization that may result in stroke. In carotid artery stenting, cerebral embolic protection devices (CEPD) such as filtering membranes have been available for already 10 years. In transcatheter aortic valve implantation (TAVI), the development of CEPD is starting and three membrane-based devices are in clinical trials. There are controversial discussions about the efficacy of CEPD in TAVI. The experience with CEPD in carotid artery stenting can help to understand some of the technical issues and shortcomings of current devices and thereby ultimately reduce cerebral complication risks during TAVI procedures.
authors.affiliation: a Department of Cardiovascular Engineering , Institute of Applied Medical Engineering AME, Helmholtz Institute , Aachen , Germany.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Egron
authors.affiliation: a Department of Cardiovascular Engineering , Institute of Applied Medical Engineering AME, Helmholtz Institute , Aachen , Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Kütting
authors.affiliation: b Department of Vascular Surgery , Henri Mondor Hospital , Créteil , France.
authors.forename: Jean
authors.initials: J
authors.lastname: Marzelle
authors.affiliation: b Department of Vascular Surgery , Henri Mondor Hospital , Créteil , France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Becquemin
authors.affiliation: a Department of Cardiovascular Engineering , Institute of Applied Medical Engineering AME, Helmholtz Institute , Aachen , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz-Rode
authors.affiliation: a Department of Cardiovascular Engineering , Institute of Applied Medical Engineering AME, Helmholtz Institute , Aachen , Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
mesh_terms: D002339:Carotid Arteries / Q000473:pathology*; D002986:Clinical Trials as Topic; D057505:Embolic Protection Devices; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology* / Q000628:therapy*; D015607:Stents; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: MRI; carotid artery stenting (CAS); cerebral embolic protection device; cerebral lesion; filter; stroke; transcatheter aortic valve implantation (TAVI)