Device Interventions for Stroke Prevention in Atrial Fibrillation

Shehata, Michael; Yeow, Wen–Loong; Kar, Saibal

doi:10.1161/circulationaha.113.003989

Cited by 2 publications

(3 citation statements)

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“…Permanent treatment options, such as surgery to remove or close the LAA or percutaneous closure devices, have been explored to circumvent the risk of bleeding associated with long-term anticoagulation therapy. Although surgical closures are often incomplete, the WATCHMAN, AMPLATZER, and LARIAT devices are the 3 closure devices that are currently being studied for percutaneous LAA closure [141]. The WATCHMAN device is the most studied and is noninferior to warfarin for preventing the combined outcomes of stroke, SE, and cardiovascular death, and superior for preventing cardiovascular and all-cause mortality [142].…”

Section: Device Interventions For Stroke Prevention In Patients With mentioning

confidence: 99%

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

Camm

Fox

2018

Current Medical Research and Opinion

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Section: Device Interventions For Stroke Prevention In Patients With mentioning

confidence: 99%

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

Camm

Fox

2018

Current Medical Research and Opinion

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“…Blockage of blood vessels in the brain leads to strokes and transient ischemic attacks. 7 The conventional therapy for stroke prevention in patients with AF is treatment with anticoagulants, but bleeding complications hinder its use in many eligible patients. Warfarin is an effective means for stroke reduction but can present challenges such as an increased bleeding risk, poor adherence rates due to daily regimen requirements, and the need to monitor the international normalized ratio (INR), as well as potential interactions with foods and certain drugs.…”

Section: ■ Introductionmentioning

confidence: 99%

“…The thrombus travels to and blocks major vessels in the body. Blockage of blood vessels in the brain leads to strokes and transient ischemic attacks . The conventional therapy for stroke prevention in patients with AF is treatment with anticoagulants, but bleeding complications hinder its use in many eligible patients.…”

Section: Introductionmentioning

confidence: 99%

Endothelium-Mimicking Nanomatrix Coating to Enhance Endothelialization after Left Atrial Appendage Closure Device Implantation

Hwang

Sherwood

Millican

et al. 2021

ACS Appl. Bio Mater.

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Blood clots (90%) originate from the left atrial appendage (LAA) in non-valvular atrial fibrillation patients and are a major cause of embolic stroke. Long-term anticoagulation therapy has been used to prevent thrombus formation, but its use is limited in patients at a high risk for bleeding complications. Thus, left atrial appendage closure (LAAC) devices for LAA occlusion are well-established as an alternative to the anticoagulation therapy. However, the anticoagulation therapy is still required for at least 45 days post-implantation to bridge the time until complete LAA occlusion by neoendocardium coverage of the device. In this study, we applied an endothelium-mimicking nanomatrix to the LAAC device membrane for delivery of nitric oxide (NO) to enhance endothelialization, with the goal of possibly being able to reduce the duration of the anticoagulation therapy. The nanomatrix was uniformly coated on the LAAC device membranes and provided sustained release of NO for up to 1 month in vitro. In addition, the nanomatrix coating promoted endothelial cell proliferation and reduced platelet adhesion compared to the uncoated device membranes in vitro. The nanomatrix-coated and uncoated LAAC devices were then deployed in a canine LAA model for 22 days as a pilot study. All LAAC devices were not completely covered by neoendocardium 22 days post-implantation. However, histology image analysis showed that the nanomatrix-coated LAAC device had thicker neoendocardium coverage compared to the uncoated device. Therefore, our in vitro and in vivo results indicate that the nanomatrix coating has the potential to enhance endothelialization on the LAAC device membrane, which could improve patient outcomes by shortening the need for extended anticoagulation treatment.

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Device Interventions for Stroke Prevention in Atrial Fibrillation

Cited by 2 publications

References 0 publications

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

Endothelium-Mimicking Nanomatrix Coating to Enhance Endothelialization after Left Atrial Appendage Closure Device Implantation

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