Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure
<strong>Objectives</strong> The aim of this study is to review the evidence on the use of antithrombotic therapy and risk of device-related thrombosis after left atrial appendage closure. <br/><br/> <strong>Background</strong> Left atrial appendage closure (LAAC)...
Main Authors: | , , , , , , |
---|---|
Format: | Journal article |
Language: | English |
Published: |
Elsevier
2019
|
_version_ | 1797105019035582464 |
---|---|
author | Saw, J Nielsen-Kudsk, JE Bergmann, M Daniels, MJ Tzikas, A Reisman, M Rana, BS |
author_facet | Saw, J Nielsen-Kudsk, JE Bergmann, M Daniels, MJ Tzikas, A Reisman, M Rana, BS |
author_sort | Saw, J |
collection | OXFORD |
description | <strong>Objectives</strong> The aim of this study is to review the evidence on the use of antithrombotic therapy and risk of device-related thrombosis after left atrial appendage closure. <br/><br/> <strong>Background</strong> Left atrial appendage closure (LAAC) is increasingly performed for stroke prevention in patients with nonvalvular atrial fibrillation, especially those who cannot tolerate or are ineligible for oral anticoagulation. <br/><br/> <strong>Methods</strong> After device implantation for LAAC, different antithrombotic regimens with varying duration of therapy are currently used. Such selection depends on patients’ risk for bleeding and physicians’ choice. <br/><br/> <strong>Results</strong> Device-related thrombosis remains an Achilles’ heel of LAAC, and the etiology remains incompletely understood. Dual-antiplatelet therapy, and direct oral anticoagulation may have similar safety and device-related thrombosis occurrence in real-world LAAC registries compared with warfarin and aspirin. Device imaging surveillance should be routinely performed to assess for device-related thrombosis, which if diagnosed should be treated aggressively, as it is associated with higher thromboembolic risks. <br/><br/> <strong>Conclusions</strong> Given the uncertainties and therapeutic dilemma, the authors provide an in-depth discussion of the options and rationale for antithrombotic therapy post-LAAC. |
first_indexed | 2024-03-07T06:41:34Z |
format | Journal article |
id | oxford-uuid:f974f499-c947-42ff-8b94-f1501aee91c9 |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-07T06:41:34Z |
publishDate | 2019 |
publisher | Elsevier |
record_format | dspace |
spelling | oxford-uuid:f974f499-c947-42ff-8b94-f1501aee91c92022-03-27T12:58:05ZAntithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closureJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f974f499-c947-42ff-8b94-f1501aee91c9EnglishSymplectic Elements at OxfordElsevier2019Saw, JNielsen-Kudsk, JEBergmann, MDaniels, MJTzikas, AReisman, MRana, BS<strong>Objectives</strong> The aim of this study is to review the evidence on the use of antithrombotic therapy and risk of device-related thrombosis after left atrial appendage closure. <br/><br/> <strong>Background</strong> Left atrial appendage closure (LAAC) is increasingly performed for stroke prevention in patients with nonvalvular atrial fibrillation, especially those who cannot tolerate or are ineligible for oral anticoagulation. <br/><br/> <strong>Methods</strong> After device implantation for LAAC, different antithrombotic regimens with varying duration of therapy are currently used. Such selection depends on patients’ risk for bleeding and physicians’ choice. <br/><br/> <strong>Results</strong> Device-related thrombosis remains an Achilles’ heel of LAAC, and the etiology remains incompletely understood. Dual-antiplatelet therapy, and direct oral anticoagulation may have similar safety and device-related thrombosis occurrence in real-world LAAC registries compared with warfarin and aspirin. Device imaging surveillance should be routinely performed to assess for device-related thrombosis, which if diagnosed should be treated aggressively, as it is associated with higher thromboembolic risks. <br/><br/> <strong>Conclusions</strong> Given the uncertainties and therapeutic dilemma, the authors provide an in-depth discussion of the options and rationale for antithrombotic therapy post-LAAC. |
spellingShingle | Saw, J Nielsen-Kudsk, JE Bergmann, M Daniels, MJ Tzikas, A Reisman, M Rana, BS Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title | Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title_full | Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title_fullStr | Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title_full_unstemmed | Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title_short | Antithrombotic therapy and device-related thrombosis following endovascular left atrial appendage closure |
title_sort | antithrombotic therapy and device related thrombosis following endovascular left atrial appendage closure |
work_keys_str_mv | AT sawj antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT nielsenkudskje antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT bergmannm antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT danielsmj antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT tzikasa antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT reismanm antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure AT ranabs antithrombotictherapyanddevicerelatedthrombosisfollowingendovascularleftatrialappendageclosure |