The evaluation of any therapy includes an assessment of benefits and risks. For percutaneous coronary interventions, death and myocardial infarction are typically selected as the 2 hard end points for describing adverse events. Stroke may be observed during percutaneous coronary intervention and be a direct result of the procedure. Fortunately, as percutaneous coronary intervention has matured, rates of stroke are <1%.1,2 Accordingly, few efforts have been directed toward lowering this event rate further. For transcatheter aortic valve replacement (TAVR), rates of stroke are substantially higher than percutaneous coronary interventions, and in the Placement of Aortic Transcatheter Valves (PARTNER) B trial, the rate at 1 year among TAVR patients was double that of patients assigned to medical therapy alone.3 From a patient standpoint, stroke is among the most feared complications of patients undergoing TAVR, often more so than death.4 Furthermore, when high-risk patients treated by TAVR using the Sapien system were compared with those treated by surgical aortic valve replacement (PARTNER A), the rate of any stroke at 30 days with TAVR clearly exceed …