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The occurrence of strokes after transcatheter aortic valve replacement is one of the most devastating complications. It has a multifactorial etiology and nearly half of the events occur during or immediately after the procedure. The use of periprocedural embolic protection devices to stop the emboli from reaching the cerebral vessels is a promising preventive strategy to reduce this complication. However, we still lack solid evidence supporting its systematic use. The REFLECT II clinical trial is a new randomized clinical trial that assessed the safety and efficacy profile of an embolic protection device in patients undergoing transcatheter aortic valve replacement.

Cerebral embolic protection device in TAVI after the REFLECT II clinical trial: does it change our strategy?