Cerebral Embolic Protection For TAVR: Start-Ups Compete

With minimally invasive left-heart procedures like transcatheter aortic valve replacement becoming increasingly safe and commonplace, attention has turned to procedure-associated brain injury from showers of emboli. Several medtech start-ups are developing devices that could protect patients’ brains during not only TAVR, but also surgical aortic valve replacement, atrial fibrillation ablation and other left-heart procedures.

With transcatheter aortic valve replacement (TAVR) becoming a mainstream procedure, worth a predicted $7.4 billion by 2025, attention is turning to the associated stroke risk. Cerebral embolic protection devices show promise in prevention, and some start-ups predict they will become standard of care for TAVR and other left-heart procedures. Some estimate a billion-dollar market potential for such ancillary devices.

Across recent large randomized trials of TAVR, the reported stroke rate is about 2.8%. However, recent studies in Europe and the US that examine post-TAVR patients with MRI have found that 68% to 100% of patients suffer new brain lesions after TAVR, even if they don’t show obvious signs of stroke

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