Percutaneous insertion of a cerebral protection device during TAVI for preventing stroke

Status:

In progress

Technology type:

Procedure

Decision:

Selected

Reason for decision:

Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources

Process:

IP

ID number:

1237

Description:

Transcatheter aortic valve implantation (TAVI) is a common procedure used to treat aortic stenosis. TAVI improves the blood flow in the heart by replacing a narrowed aortic valve that does not open fully. It provides a less invasive alternative to open cardiac surgery, avoiding the need for sternotomy and cardiopulmonary bypass. It is primarily used in people who are at high risk for open heart surgery or when surgery is inappropriate. However, debris may be dislodged during the TAVI procedure. This can enter the cerebral circulation and embolise, causing cerebral ischaemic events including a stroke. Percutaneous insertion of a cerebral protection device is to prevent debris dislodged during TAVI from passing into the cerebral circulation. The aim is to reduce the risk of cerebral ischaemic events including a stroke. During the TAVI procedure, before the valve is inserted, a cerebral protection device is inserted percutaneously through the radial or femoral artery. Depending on the type of device used, it is placed into the aortic arch or into the brachiocephalic and left common carotid arteries (major blood vessels that branches off from the aortic arch which supply the upper part of the body including the brain). It is used to protect the ostia of the brachiocephalic artery and the left common carotid artery. It may also protect the left subclavian artery, depending on the type of device used. It works by filtering dislodged debris from the blood, or by deflecting dislodged debris away from the cerebral circulation to the systemic circulation. The device is removed at the end of the TAVI procedure. This is a review of existing NICE’s guidance on percutaneous insertion of a cerebral protection device to prevent cerebral embolism during transcatheter aortic valve implantation. This is an interventional procedures assessment which aims to assess the efficacy and safety of the procedure.

Provisional Schedule

Final scope:

11 March 2026

Email enquiries

If you have any queries please email HealthTech3@nice.org.uk

Timeline

Key events during the development of the guidance:

For further information on how we develop interventional procedures guidance, please see our interventional procedures programme manual