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Highlights the potential for late recurrence of device-related thrombus after LAAO and identifies key patient and procedural risk factors to guide long-term follow-up imaging.
•Device-related thrombus (DRT) may occur any time following left atrial appendage occlusion (LAAO), and follow-up imaging may be necessary one year or more after LAAO in patients at risk for DRT, given the predisposition of having a stroke with a DRT.•Patient risk factors for DRT: history of stroke, venous thromboembolism, permanent atrial fibrillation, vascular disease, ejection fraction less than 50%, hypercoagulability disorder, pericardial effusion, discontinuing anticoagulation or DAPT before the prescribed regimen is finished, and a larger LAA diameter.•Procedural risk factors for DRT: larger device size, deep implantation of the device below the ostial plane (>10 mm from pulmonary vein ridge/limbus; leaving uncovered residual LAA), and peri-device flow.
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Cantú-Martínez et al. (2023) studied this question.
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