AUTHOR=Jimenez Diaz Victor Alfonso , Estevez Loureiro Rodrigo , Baz Alonso Jose Antonio , Juan Salvadores Pablo , Bastos Fernandez Guillermo , Caneiro Queija Berenice , Veiga Garcia Cesar , Iñiguez Romo Andres 

TITLE=Stroke prevention during and after transcatheter aortic valve implantation: From cerebral protection devices to antithrombotic management

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.958732

DOI=10.3389/fcvm.2022.958732

ISSN=2297-055X

ABSTRACT=Since its conception, TAVI has undergone important improvements both in the implantation technique and in transcatheter devices, allowing an enthusiastic adoption of this therapeutic approach to a wide population of patients previously without surgical option and managed conservatively. Nowadays, TAVI has become the preferred management strategy in most patients with severe symptomatic aortic stenosis regardless of their surgical risk, improving the prognosis of patients, and thus achieving an exponential global expansion of its use. However, thromboembolic and hemorrhagic complications remain a latent concern in TAVI recipients. Both complications can appear simultaneously in the periprocedural period or during follow-up, and when minor they resolved without apparent sequelae, but in a relevant percentage of cases they are devastating, overshadowing the benefit achieved with TAVI. In this review we outline the etiology and incidence of thromboembolic complications after TAVI, the main current strategies for their prevention, and the implications of its pharmacological management at follow-up in a TAVI population, mostly frail and predisposed to bleeding complications.