{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:00:31Z","timestamp":1789992031488,"version":"4.0.1"},"reference-count":91,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,2,25]],"date-time":"2019-02-25T00:00:00Z","timestamp":1551052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Transcatheter aortic valve implantation (TAVI) has emerged as an important alternative to surgical aortic valve repair (SAVR) for patients with severe aortic stenosis. This rapidly advancing field has produced new-generation devices being delivered with small delivery sheaths, embolic protection devices and improved retrieval features. Despite efforts to reduce the rate of thrombotic complications associated with TAVI, valve thrombosis and cerebral ischaemic events post-TAVI continue to be a significant issue. However, the antithrombotic treatments utilised to prevent these dreaded complications are based on weak evidence and are associated with high rates of bleeding, which in itself is associated with adverse clinical outcomes. Recently, experimental data has shed light on the unique mechanisms, particularly the complex haemodynamic changes at sites of TAVI, that underpin the development of post-TAVI thrombosis. These new insights regarding the drivers of TAVI-associated thrombosis, coupled with the ongoing development of novel antithrombotics which do not cause bleeding, hold the potential to deliver newer, safer therapeutic paradigms to prevent post-TAVI thrombotic and bleeding complications. This review highlights the major challenge of post-TAVI thrombosis and bleeding, and the significant issues surrounding current antithrombotic approaches. Moreover, a detailed discussion regarding the mechanisms of post-TAVI thrombosis is provided, in addition to an appraisal of current antithrombotic guidelines, past and ongoing clinical trials, and how novel therapeutics offer the hope of optimizing antithrombotic strategies and ultimately improving patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm8020280","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T11:00:44Z","timestamp":1551178844000},"page":"280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Thromboembolic and Bleeding Complications in Transcatheter Aortic Valve Implantation: Insights on Mechanisms, Prophylaxis and Therapy"],"prefix":"10.3390","volume":"8","author":[{"given":"Mark","family":"Ranasinghe","sequence":"first","affiliation":[{"name":"Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia"},{"name":"Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karlheinz","family":"Peter","sequence":"additional","affiliation":[{"name":"Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia"},{"name":"Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia"},{"name":"Heart Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"McFadyen","sequence":"additional","affiliation":[{"name":"Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia"},{"name":"Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia"},{"name":"Department of Clinical Haematology, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1313875","article-title":"Aortic-Valve Stenosis\u2014From Patients at Risk to Severe Valve Obstruction","volume":"371","author":"Otto","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/nrcardio.2010.202","article-title":"Epidemiology of valvular heart disease in the adult","volume":"8","author":"Iung","year":"2011","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery","volume":"363","author":"Leon","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1016\/j.jacc.2014.02.556","article-title":"Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery","volume":"63","author":"Popma","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1056\/NEJMoa1103510","article-title":"Transcatheter versus surgical aortic-valve replacement in high-risk patients","volume":"364","author":"Smith","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1161\/01.CIR.0000047200.36165.B8","article-title":"Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description","volume":"106","author":"Cribier","year":"2002","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2714","DOI":"10.1093\/eurheartj\/ehi471","article-title":"Decision-making in elderly patients with severe aortic stenosis: Why are so many denied surgery?","volume":"26","author":"Iung","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"Y46","DOI":"10.4244\/EIJV12SYA11","article-title":"Patient selection for TAVI in 2016: Should we break through the low-risk barrier?","volume":"12","author":"Abdelghani","year":"2016","journal-title":"EuroIntervention"},{"key":"ref_10","first-page":"51","article-title":"Trends in European TAVI Practice","volume":"12","author":"Costa","year":"2018","journal-title":"Card. Interv. Today"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1056\/NEJMoa1400590","article-title":"Transcatheter aortic-valve replacement with a self-expanding prosthesis","volume":"370","author":"Adams","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jacc.2015.05.017","article-title":"2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement","volume":"66","author":"Reardon","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.1093\/eurheartj\/ehx390","article-title":"Thrombo-embolic prevention after transcatheter aortic valve implantation","volume":"38","author":"Vranckx","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"846","DOI":"10.4244\/EIJV14I8A151","article-title":"Transcatheter aortic valve looking for low-risk patients: A post hoc analysis of SURTAVI keeps opening the door","volume":"14","author":"Bagur","year":"2018","journal-title":"EuroIntervention"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.cjca.2016.12.001","article-title":"Risk Factors for Post-TAVI Bleeding According to the VARC-2 Bleeding Definition and Effect of the Bleeding on Short-Term Mortality: A Meta-analysis","volume":"33","author":"Wang","year":"2017","journal-title":"Can. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.athoracsur.2016.01.105","article-title":"Comparison of EuroSCORE II, Original EuroSCORE, and The Society of Thoracic Surgeons Risk Score in Cardiac Surgery Patients","volume":"102","author":"Ad","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5301\/heartint.5000214","article-title":"Heart valve surgery: EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons score","volume":"9","author":"Rabbani","year":"2014","journal-title":"Heart Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"136","DOI":"10.5694\/mja17.01255","article-title":"Transcatheter aortic valve implantation: A new standard of care","volume":"209","author":"Nelson","year":"2018","journal-title":"Med. J. Aust."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.jcin.2012.06.011","article-title":"The impact of frailty status on survival after transcatheter aortic valve replacement in older adults with severe aortic stenosis: A single-center experience","volume":"5","author":"Green","year":"2012","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jcin.2017.06.060","article-title":"Effects of Body Mass Index on Clinical Outcomes in Female Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents: Results from a Patient-Level Pooled Analysis of Randomized Controlled Trials","volume":"11","author":"Faggioni","year":"2018","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.atherosclerosis.2010.07.047","article-title":"Atherosclerotic-like process in aortic stenosis: Activation of the tissue factor-thrombin pathway and potential role through osteopontin alteration","volume":"213","author":"Breyne","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.carpath.2007.12.014","article-title":"Identification of tissue factor in experimental aortic valve sclerosis","volume":"18","author":"Marechaux","year":"2009","journal-title":"Cardiovasc. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1016\/j.jcin.2011.08.012","article-title":"A high-risk period for cerebrovascular events exists after transcatheter aortic valve implantation","volume":"4","author":"Tay","year":"2011","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1001\/jama.2012.54506","article-title":"Association of warfarin therapy duration after bioprosthetic aortic valve replacement with risk of mortality, thromboembolic complications, and bleeding","volume":"308","author":"Merie","year":"2012","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"78","DOI":"10.4244\/EIJV5I1A12","article-title":"Anatomo-pathological analysis after CoreValve Revalving system implantation","volume":"5","author":"Noble","year":"2009","journal-title":"EuroIntervention"},{"key":"ref_27","unstructured":"Grillo, J. (2018, January 04). Yoganathan lab leads new research in formation of transcatheter heart valve thrombosis. Available online: http:\/\/www.rh.gatech.edu\/news\/599221\/rave-review-heart-valve-study."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"717","DOI":"10.4244\/EIJ-D-17-00468","article-title":"State of the art: Duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation\u2014past, present and future perspectives","volume":"13","author":"Gargiulo","year":"2017","journal-title":"EuroIntervention"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1161\/CIRCULATIONAHA.116.023952","article-title":"A Critical Appraisal of Aspirin in Secondary Prevention: Is Less More?","volume":"134","author":"Gargiulo","year":"2016","journal-title":"Circulation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1016\/j.jacc.2015.05.085","article-title":"Meta-Analyses of Dual Antiplatelet Therapy Following Drug-Eluting Stent Implantation: Do Bleeding and Stent Thrombosis Weigh Similar on Mortality?","volume":"66","author":"Capodanno","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","first-page":"804","article-title":"Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial","volume":"38","author":"Valgimigli","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/S0140-6736(17)30397-5","article-title":"Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: A pooled analysis of individual-patient datasets from clinical trials","volume":"389","author":"Costa","year":"2017","journal-title":"Lancet"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"i5483","DOI":"10.1136\/bmj.i5483","article-title":"Short term versus long term dual antiplatelet therapy after implantation of drug eluting stent in patients with or without diabetes: Systematic review and meta-analysis of individual participant data from randomised trials","volume":"355","author":"Gargiulo","year":"2016","journal-title":"BMJ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.jcin.2016.05.046","article-title":"Impact of Sex on 2-Year Clinical Outcomes in Patients Treated with 6-Month or 24-Month Dual-Antiplatelet Therapy Duration: A Pre-Specified Analysis from the PRODIGY Trial","volume":"9","author":"Gargiulo","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4260","DOI":"10.21037\/jtd.2017.10.28","article-title":"Antithrombotic therapy after transcatheter aortic valve implantation: A new piece of the still unresolved puzzle","volume":"9","author":"Gargiulo","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/nm.1955","article-title":"A shear gradient-dependent platelet aggregation mechanism drives thrombus formation","volume":"15","author":"Nesbitt","year":"2009","journal-title":"Nat. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1038\/s41467-018-03430-6","article-title":"Compression force sensing regulates integrin \u03b1IIb\u03b23 adhesive function on diabetic platelets","volume":"9","author":"Ju","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ijcard.2015.10.133","article-title":"New-onset atrial fibrillation and increased mortality after transcatheter aortic valve implantation: A causal or spurious association?","volume":"203","author":"Gargiulo","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e1047","DOI":"10.4244\/EIJY15M11_12","article-title":"A meta-analysis of the impact of pre-existing and new-onset atrial fibrillation on clinical outcomes in patients undergoing transcatheter aortic valve implantation","volume":"12","author":"Sannino","year":"2016","journal-title":"EuroIntervention"},{"key":"ref_40","first-page":"A15761","article-title":"Abstract 15761: New Onset Atrial Fibrillation After Transcatheter Aortic Valve Implantation: A Pooled Meta-Analysis","volume":"130","author":"Kanmanthareddy","year":"2018","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1136\/heartjnl-2017-312310","article-title":"New-onset arrhythmias following transcatheter aortic valve implantation: a systematic review and meta-analysis","volume":"104","author":"Siontis","year":"2018","journal-title":"Heart"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1161\/CIRCULATIONAHA.112.001091","article-title":"Histopathology of embolic debris captured during transcatheter aortic valve replacement","volume":"127","author":"Schipper","year":"2013","journal-title":"Circulation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jacc.2016.10.023","article-title":"Protection Against Cerebral Embolism During Transcatheter Aortic Valve Replacement","volume":"69","author":"Kapadia","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.jacc.2012.09.001","article-title":"Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document","volume":"60","author":"Kappetein","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"129","DOI":"10.4244\/EIJV8I1A20","article-title":"Risk of stroke after transcatheter aortic valve implantation (TAVI): A meta-analysis of 10,037 published patients","volume":"8","author":"Eggebrecht","year":"2012","journal-title":"EuroIntervention"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Seeger, J., Kapadia, S.R., Kodali, S., Linke, A., W\u00f6hrle, J., Haussig, S., Makkar, R., Mehran, R., Rottbauer, W., and Leon, M. Rate of peri-procedural stroke observed with cerebral embolic protection during transcatheter aortic valve replacement: A patient-level propensity-matched analysis. Eur. Heart J., 2018.","DOI":"10.1093\/eurheartj\/ehy847"},{"key":"ref_47","first-page":"37","article-title":"Assessing the Risk of Leaflet Motion Abnormality Following Transcatheter Aortic Valve Implantation","volume":"13","author":"Testa","year":"2018","journal-title":"Interv. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1016\/S0140-6736(17)30757-2","article-title":"Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study","volume":"389","author":"Chakravarty","year":"2017","journal-title":"Lancet"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e001779","DOI":"10.1161\/CIRCINTERVENTIONS.114.001779","article-title":"Treatment and clinical outcomes of transcatheter heart valve thrombosis","volume":"8","author":"Latib","year":"2015","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.jcin.2017.01.045","article-title":"Clinical Bioprosthetic Heart Valve Thrombosis After Transcatheter Aortic Valve Replacement: Incidence, Characteristics, and Treatment Outcomes","volume":"10","author":"Jose","year":"2017","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.carrev.2018.03.003","article-title":"A meta-analysis of reduced leaflet motion for surgical and transcatheter aortic valves: Relationship to cerebrovascular events and valve degeneration","volume":"19","author":"Makki","year":"2018","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jacc.2015.10.097","article-title":"Incidence, Timing, and Predictors of Valve Hemodynamic Deterioration After Transcatheter Aortic Valve Replacement: Multicenter Registry","volume":"67","author":"Wijeysundera","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00392-016-1052-3","article-title":"Course of early subclinical leaflet thrombosis after transcatheter aortic valve implantation with or without oral anticoagulation","volume":"106","author":"Ruile","year":"2017","journal-title":"Clin. Res. Cardiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.jcin.2018.04.006","article-title":"Medium-Term Follow-Up of Early Leaflet Thrombosis After Transcatheter Aortic Valve Replacement","volume":"11","author":"Ruile","year":"2018","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1080\/24748706.2017.1366086","article-title":"Clinical or Symptomatic Leaflet Thrombosis Following Transcatheter Aortic Valve Replacement: Insights from the U.S. FDA MAUDE Database","volume":"1","author":"Hafiz","year":"2017","journal-title":"Struct. Heart"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1038\/nrcardio.2017.206","article-title":"Current and future antiplatelet therapies: Emphasis on preserving haemostasis","volume":"15","author":"McFadyen","year":"2018","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1016\/j.jacc.2014.02.537","article-title":"2014 AHA\/ACC guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Nishimura","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e1159","DOI":"10.1161\/CIR.0000000000000503","article-title":"2017 AHA\/ACC Focused Update of the 2014 AHA\/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"135","author":"Nishimura","year":"2017","journal-title":"Circulation"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2451","DOI":"10.1093\/eurheartj\/ehs109","article-title":"Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"33","author":"Vahanian","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e576S","DOI":"10.1378\/chest.11-2305","article-title":"Antithrombotic and Thrombolytic Therapy for Valvular Disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Fremes","year":"2012","journal-title":"Chest"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1136\/heartjnl-2014-307053","article-title":"Antiplatelet therapy following transcatheter aortic valve implantation","volume":"101","author":"Hassell","year":"2015","journal-title":"Heart"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1159\/000490307","article-title":"Single versus Dual Antiplatelet Therapy after Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis","volume":"141","author":"Hu","year":"2018","journal-title":"Cardiology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e000748","DOI":"10.1136\/openhrt-2017-000748","article-title":"Optimal antiplatelet strategy after transcatheter aortic valve implantation: A meta-analysis","volume":"5","author":"Ahmad","year":"2018","journal-title":"Open Heart"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jcct.2017.11.002","article-title":"Leaflet thrombosis following transcatheter aortic valve implantation","volume":"12","author":"Marwan","year":"2018","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1055\/s-0037-1607457","article-title":"Antithrombotic Treatment after Transcatheter Heart Valves Implant","volume":"44","author":"Sorrentino","year":"2018","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jcin.2016.11.024","article-title":"Antithrombotic Management After Transcatheter Aortic Valve Replacement","volume":"10","author":"Sawaya","year":"2017","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jacc.2018.08.1045","article-title":"Long-Term Mortality and Early Valve Dysfunction According to Anticoagulation Use: The FRANCE TAVI Registry","volume":"73","author":"Overtchouk","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1016\/j.jcin.2016.06.025","article-title":"Warfarin and Antiplatelet Therapy Versus Warfarin Alone for Treating Patients with Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement","volume":"9","author":"Durand","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1056\/NEJMoa1611594","article-title":"Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI","volume":"375","author":"Gibson","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.4244\/EIJ-D-15-00259","article-title":"Feasibility and safety of vitamin K antagonist monotherapy in atrial fibrillation patients undergoing transcatheter aortic valve implantation","volume":"12","author":"Geis","year":"2017","journal-title":"EuroIntervention"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0140-6736(12)62177-1","article-title":"Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial","volume":"381","author":"Dewilde","year":"2013","journal-title":"Lancet"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"472.e5","DOI":"10.1016\/j.ahj.2014.12.006","article-title":"An open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention (PIONEER AF-PCI)","volume":"169","author":"Gibson","year":"2015","journal-title":"Am. Heart J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jcin.2016.10.023","article-title":"Apixaban in Patients with Atrial Fibrillation After Transfemoral Aortic Valve Replacement","volume":"10","author":"Seeger","year":"2017","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_74","unstructured":"(2018, October 15). Greater Risks with Post-TAVR Rivaroxaban Halt GALILEO Trial. Available online: https:\/\/www.medscape.com\/viewarticle\/903230?src=soc_tw_181013_mscpedt_news_tho_galileo&faf=1."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ahj.2015.11.008","article-title":"Rationale and design of POPular-TAVI: AntiPlatelet therapy for Patients undergoing Transcatheter Aortic Valve Implantation","volume":"173","author":"Nijenhuis","year":"2016","journal-title":"Am. Heart J."},{"key":"ref_76","unstructured":"ClinicalTrials.gov (2018, December 03). Anti-Thrombotic Strategy After Trans-Aortic Valve Implantation for Aortic Stenosis (ATLANTIS), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02664649."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ahj.2018.07.006","article-title":"Edoxaban Versus standard of care and their effects on clinical outcomes in patients having undergone Transcatheter Aortic Valve Implantation in Atrial Fibrillation-Rationale and design of the ENVISAGE-TAVI AF trial","volume":"205","author":"Unverdorben","year":"2018","journal-title":"Am. Heart J."},{"key":"ref_78","unstructured":"ClinicalTrials.gov (2018, December 12). Dual Antiplatelet Therapy Versus Oral Anticoagulation for a Short Time to Prevent Cerebral Embolism After TAVI (AUREA), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01642134."},{"key":"ref_79","unstructured":"ClinicalTrials.gov (2018, December 12). Anticoagulation Alone Versus Anticoagulation and Aspirin Following Transcatheter Aortic Valve Interventions (1:1) (AVATAR), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02735902."},{"key":"ref_80","unstructured":"ClinicalTrials.gov (2018, December 12). Global Study Comparing a rivAroxaban-based Antithrombotic Strategy to an antipLatelet-based Strategy After Transcatheter aortic valve replacement to Optimize Clinical Outcomes (GALILEO), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02556203."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1161\/CIRCRESAHA.117.312012","article-title":"Novel Antithrombotic Drugs on the Horizon: The Ultimate Promise to Prevent Clotting While Avoiding Bleeding","volume":"121","author":"McFadyen","year":"2017","journal-title":"Circ. Res."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1161\/CIRCRESAHA.114.301808","article-title":"Thiol isomerases in thrombus formation","volume":"114","author":"Furie","year":"2014","journal-title":"Circ. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"eaaf5294","DOI":"10.1126\/scitranslmed.aaf5294","article-title":"Blockade of protease-activated receptor-4 (PAR4) provides robust antithrombotic activity with low bleeding","volume":"9","author":"Wong","year":"2017","journal-title":"Sci. Transl. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1038\/nm1232","article-title":"PI 3-kinase p110beta: A new target for antithrombotic therapy","volume":"11","author":"Jackson","year":"2005","journal-title":"Nat. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1056\/NEJMoa1300615","article-title":"Dabigatran versus warfarin in patients with mechanical heart valves","volume":"369","author":"Eikelboom","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/ATVBAHA.117.309223","article-title":"Anticoagulation for Mechanical Heart Valves: Will Oral Factor Xa Inhibitors Be Effective?","volume":"37","author":"Chan","year":"2017","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"222ra17","DOI":"10.1126\/scitranslmed.3006804","article-title":"A factor XIIa inhibitory antibody provides thromboprotection in extracorporeal circulation without increasing bleeding risk","volume":"6","author":"Larsson","year":"2014","journal-title":"Sci. Transl. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1161\/ATVBAHA.116.306483","article-title":"Molecular Imaging of Atherothrombotic Diseases: Seeing Is Believing","volume":"37","author":"Wang","year":"2017","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"726","DOI":"10.7150\/thno.14514","article-title":"Thrombus-Targeted Theranostic Microbubbles: A New Technology towards Concurrent Rapid Ultrasound Diagnosis and Bleeding-free Fibrinolytic Treatment of Thrombosis","volume":"6","author":"Wang","year":"2016","journal-title":"Theranostics"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1161\/CIRCRESAHA.114.302514","article-title":"Towards effective and safe thrombolysis and thromboprophylaxis: preclinical testing of a novel antibody-targeted recombinant plasminogen activator directed against activated platelets","volume":"114","author":"Wang","year":"2014","journal-title":"Circ. Res."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s10439-017-1801-0","article-title":"The Pursuit of Engineering the Ideal Heart Valve Replacement or Repair: A Special Issue of the Annals of Biomedical Engineering","volume":"45","author":"Dasi","year":"2017","journal-title":"Ann. Biomed. Eng."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/2\/280\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:34:40Z","timestamp":1760186080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/2\/280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,25]]},"references-count":91,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["jcm8020280"],"URL":"https:\/\/doi.org\/10.3390\/jcm8020280","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,25]]}}}