Background: Cerebrovascualr events following transcatheter aortic valve implantation (TAVI) are of major clinical importance, therefore investigating their possible etiologies might be of particular interest. Little is known on the prevalence of carotid artery stenosis (CAS) in aortic stenosis (AS) patients referred to TAVI. In the present analysis we evaluated the prevalence and predictors of CAS in these patients.
Methods: We prospectively collected data on consecutive patients undergoing carotid Doppler studies the day before TAVI starting from august 2012. Logistic regression models were used to identify independent correlates of CAS.
Results: The study population included 126 patients (age 82±6, male gender 45%). Carotid artery stenosis of any degree was noted in 122 (97%) of patients. Clinically significant CAS (peak systolic velocity [PSV] ≥125 cm/sec corresponding to ≥50% diameter stenosis) was found in 44 (35%) patients, whereas severe CAS (PSV≥230 cm/sec corresponding to ≥70% stenosis, or near occlusion) was found in 11 (9%) patients.In multivariate logistic regression models smoking history, a higher Euroscore and CAD predicted the presence of clinically significant CAS. Mortality or stroke rates up to 1 year following the procedure however, were unaffected by the presence of clinically significant CAS. Finally, when comparing the present TAVI cohort to a previous cohort of 492 patients ≥70 years old, undergoing non-emergent coronary angiography and same day carotid Doppler, we have found a significantly higher prevalence of ≥50% CAS in TAVI patients (35% vs' 20%, odd ratio=2.1, p=0.001).
Conclusions: The prevalence of clinically significant CAS in AS patients referred to TAVI is high and related to the presence of angiographically verified CAD. In this limited patient cohort however, it did not affect post procedural outcomes.
