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Page 12 of 14 Saadi et al. Vessel Plus 2020;4:41 I http://dx.doi.org/10.20517/2574-1209.2020.54

for pre- and post-dilatation), and highly calcified anatomies (e.g., extensive atherosclerosis, complex aortic
atheroma, bicuspid aortic valve, severe left ventricular outflow tract calcification).

2. Routine preventive strategy: If TAVI is performed in a center without CEPD use restrictions, one
possible approach could be to offer it routinely as long as there is adequate anatomy, heart team indication,
and patient concordance. This approach is based on the fact that captured debris are presented in almost all
[40]
patients , regardless of preoperative risk factors or type of device used.
CONCLUSION
This review article discusses the pros and cons of cerebral embolic protection use during TAVI procedures.
Despite CEPD’s high cost, recent evidence, especially with the Sentinel system, has suggested that cerebral
protection employment may lower stroke and even mortality rates. Ongoing and upcoming trials will help
to fill some of the current evidence gaps related to CEPD use during TAVI.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design and review of this manuscript: Saadi EK, Saadi
RP, Tagliari AP, Taramasso M

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Dr. Saadi EK is a consultant and Proctor for Medtronic, Abbott and Edwards and received speaker
honoraria from Edwards and Medtronic. Dr. Tagliari AP has received a Research Grant from Coordenação
de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (Capes) - Finance Code 001. Dr. Taramasso M
is a consultant for Abbott Vascular, Boston Scientific, 4TECH, and CoreMedic; he has received speaker
honoraria or Consultant fees from Edwards Lifesciences, CoreMedic, SwissVortex and Mitraltech.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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