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Over the past two decades, transcatheter aortic valve implantation (TAVI) has undergone remarkable refinement. Advances in device technology, imaging-based procedural planning and operator experience have curtailed many of the most feared procedural complications, including aortic root rupture, paravalvular regurgitation, coronary obstruction, valve migration and vascular injury. Stroke, however, remains a stubborn exception.1 2 Its impact extends far beyond the index hospitalisation, carrying profound consequences for early mortality and long-term disability. Yet, despite sustained research efforts, neither risk stratification nor preventive strategies have proven sufficiently effective. Reported risk factors for early stroke after TAVI have remained inconsistent across studies3 (table 1), and no risk model has proven sufficiently robust for routine clinical use. Cerebral embolic protection was widely anticipated to be a game changer for stroke prevention after TAVI; however, the leading device ultimately failed to demonstrate clear efficacy in large randomised trials.4