Rationale for cerebral protection in patients with left atrial appendage thrombus during percutaneous left atrial appendage closure: a single-center initial experience

Streb, Witold; Mitręga, Katarzyna; Podolecki, Tomasz; Kowalska, Wiktoria; Sawicka, Magdalena; Kalarus, Zbigniew

doi:10.20452/pamw.15711

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…In this study, a cerebral protection system consisting of a filter composed of 120 μm micropores and a filter delivery wire was used in Patients A and E. The operator inserted 6F sheaths and deployed two filters into both internal carotid arteries through the femoral arteries to prevent devastating stroke complications. Previous studies have demonstrated the effectiveness of the cerebral protection system for periprocedural stroke prevention in patients with LAAT ( 16 , 24 , 25 ). However, despite the implantation of such a protection system, cerebral ischemic events still cannot be completely eliminated because the vertebral artery is unprotected.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous left atrial appendage closure using the LAmbre device in patients with atrial fibrillation and left atrial appendage thrombus

Jin

Lin

et al. 2022

Front. Cardiovasc. Med.

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BackgroundLeft atrial appendage closure (LAAC) is considered a valid alternative for the prevention of thromboembolic stroke in patients with persistent left atrial appendage thrombus (LAAT) despite adequate anticoagulation. However, the data on LAAC using the LAmbre device for patients with LAAT is limited. This study was performed to explore efficacy and safety as well as to share the experience of the modified LAAC procedure with the LAmbre device.Materials and methodsA total of 7 patients with persistent LAAT despite adequate anticoagulation underwent modified LAAC with the LAmbre device between November 2019 and April 2022. Transesophageal echocardiography was performed 3 months postoperatively to detect device-related thrombosis and peridevice leak. The patients’ clinical events were evaluated during the perioperative and follow-up periods.ResultsThe median age, CHA2DS2-VASc score, and HAS-BLED score of all patients were 71 [53–73], 3 [2–4], and 2 [2–3], respectively. In the procedure, a cerebral protection system was used in two patients. LAAC with the LAmbre device was successfully performed in all patients without perioperative events. During the median follow-up of 383 [325–865] days, postoperative transesophageal echocardiography was performed in six (85.7%) patients. Device-related thrombosis was detected in one (16.7%) patient, and no significant peridevice leak was observed. No thromboembolic event or bleeding event occurred in any patients.ConclusionLAAC with the LAmbre device is effective and safe when performed by experienced operators in highly selected patients with LAAT after adequate anticoagulation.

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Section: Discussionmentioning

confidence: 99%

Percutaneous left atrial appendage closure using the LAmbre device in patients with atrial fibrillation and left atrial appendage thrombus

Jin

Lin

et al. 2022

Front. Cardiovasc. Med.

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“…Embolic protection devices cannot fully guarantee the probability of no stroke events, which is a problem to be considered, nor do they exclude the possibility of non-obvious cerebrovascular or other vascular embolisms. [71] From 2018 to 2020, in the Thrombus tRAPing EUropean Registry (TRAPEUR) study, which included 1,918 patients undergoing LAAC, a thrombus trapping procedure (TTP)-LAAC was performed in 53 cases (3%), Amplatzer Amulet and Watchman-FLX occludes were implanted, and a cerebral embolic protection system was used in 9% of the patients. The overall success rate was 100%.…”

Section: Laac Treatment For Laat In Patients With Afmentioning

confidence: 99%

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

Zhao

Zhang

2023

Cardiology Discovery

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Cardiac thrombus in patients with atrial fibrillation (AF) is most commonly found in the left atrial appendage (LAA). The incidence of LAA thrombus ranges from 1.2% to 22.6%, with the vast variation in incidence attributed to the patient’s condition. The effective rate of anticoagulation for thrombus dissolution therapy is only 50%–60%, and long-term anticoagulation treatment increases the risk of bleeding. Direct percutaneous LAA closure in AF patients with LAA thrombus in a suitable location is another alternative treatment option. LAA resection with cardiac surgery is also an effective treatment. This review presents the development of the incidence, diagnosis, and treatment of thrombus in LAA.

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Rationale for cerebral protection in patients with left atrial appendage thrombus during percutaneous left atrial appendage closure: a single-center initial experience

Cited by 2 publications

References 7 publications

Percutaneous left atrial appendage closure using the LAmbre device in patients with atrial fibrillation and left atrial appendage thrombus

Percutaneous left atrial appendage closure using the LAmbre device in patients with atrial fibrillation and left atrial appendage thrombus

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

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