Device Thrombosis After Percutaneous Left Atrial Appendage Occlusion Is Related to Patient and Procedural Characteristics but Not to Duration of Postimplantation Dual Antiplatelet Therapy

Abstract

In this real-world series, DRT was observed early, late, and very late after left atrial appendage occlusion. It was related to patient and procedural characteristics but not to postimplantation dual antiplatelet therapy duration.

Late clinical outcomes of lambre versus amplatzer occluders for left atrial appendage closure

“…[14][15][16] The known risk factor for the occurrence of DRT is deep implantation of the device into the neck of the LAA, older age, history of stroke, smoking, and female sex. [25][26][27] In the present study, the rate of all-cause stroke and systemic embolism at follow-up was similar for both devices but slightly higher than reported in other Amplatzer registries (ACP: 2.3%, 6 2.9%:…”

Sudden floating thrombus formation on the delivery cable before Amplatzer‐Amulet device deployment during left atrial appendage occlusion: The need for a standardized anticoagulation

“…Recently, the device‐related thrombus has been described as an important issue for both Amplatzer (Abbott, St. Paul, MN) and Watchman (Boston Scientific Corporation, Marlborough, MA) devices, and although it is unfrequent, it is associated with a four to five fold increase in ischemic events . Nevertheless, device‐related thrombosis regards above all the post‐procedural period after LAAOP, and many factors related to patient and procedural characteristics but not to postimplantation dual antiplatelet therapy duration have been reported as predictors . Accordingly, in our patient, because the hemorrhagic risk was judged extremely high by a multidisciplinary team beyond the HAS‐BLED score, a single antiplatelet therapy after the discharge was deemed enough and the TEE performed 60 days after LAAOP did not show device thrombosis and confirmed the good result of the intervention.…”

“…(A) Windsock-shaped LAA without thrombus in two orthogonal planes at TEE; (B and C) 2D and 3D TEE views showing a floating thrombus connected to the DC; (D) retrieval of thrombus which was strictly joined to the DC [Color figure can be viewed at wileyonlinelibrary.com] TALANAS ET AL. 409Nevertheless, device-related thrombosis regards above all the post-procedural period after LAAOP, and many factors related to patient and procedural characteristics but not to postimplantation dual antiplatelet therapy duration have been reported as predictors 5. Accordingly, in our patient, because the hemorrhagic riskwas judged extremely high by a multidisciplinary team beyond the HAS-BLED score, a single antiplatelet therapy after the discharge was deemed enough and the TEE performed 60 days after LAAOP did not show device thrombosis and confirmed the good result of the intervention.…”

What Lies Beneath Left Atrial Appendage Occlusion

“…Such PDL rates were 5% for Amplatzer devices and 15% for Watchman devices in this study. 1 Again, there is probably no clinical meaning to that.…”

“…I n this issue of Circulation: Cardiovascular Interventions, a Polish institution carefully analyzed ≈100 patients undergoing left atrial appendage (LAA) occlusion with serial transesophageal echocardiographies or computer tomographies at 1.5 (early), 3 to 6 (late), and 12 (very late) months with particular focus on device-related thrombus (DRT) and peridevice leak (PDL). 1 The patients were treated without oral anticoagulation but with dual antiplatelet therapy for 1 to 6 months at the discretion of the operators. DRT was diagnosed in 7%.…”