Neurologic Complications after Transcatheter Aortic Valve Replacement: An Updated Review of Incidence, Current Treatments, and Future Directions.

Transcatheter aortic valve replacement (TAVR) is the standard treatment for severe aortic stenosis, yet stroke remains a persistent complication with significant morbidity. This review summarizes the incidence, timing, mechanisms, and predictors of TAVR-related stroke, highlighting procedural embolization and patient comorbidities. We examine evidence for cerebral embolic protection devices, pharmacologic strategies, and left atrial appendage closure in mitigating risk. Despite advances in technology, randomized trials have not shown consistent stroke reduction with embolic protection. Optimal prevention requires individualized strategies balancing thromboembolic and bleeding risks across acute, subacute, and late post-TAVR periods.