Transcatheter aortic valve implantation and internal carotid artery stenting in a 74-year-old female patient

This article presents the case of a combined intervention for transcatheter aortic valve implantation (TAVI) and stenting of the internal carotid artery. Due to severe aortic stenosis and a subacute infarction in the middle cerebral artery territory, with neurological instability while hypotensive and cardiac failure while hypertensive, it was decided to carry out the intervention as a single combined procedure. An open surgical intervention was decided against because of the high peri-interventional mortality risk. The intervention was complication-free but a slight subarachnoid hemorrhage occurred in the postinterventional period. It was unclear if the bleeding was the result of cerebral hyperperfusion poststenting, if bleeding in an ischemic region was favored by post-TAVI hyperemia and whether the outcome would have been better with two separate interventions.