Why the study?
Do percutaneous endovascular and epicardial left atrial appendage closure devices safely and effectively prevent thromboembolic stroke in patients with atrial fibrillation?
Do percutaneous endovascular and epicardial left atrial appendage closure devices safely and effectively prevent thromboembolic stroke in patients with atrial fibrillation?
This narrative review summarizes the clinical evidence and technical evolution of percutaneous endocardial and epicardial left atrial appendage closure devices as mechanical alternatives to systemic anticoagulation for stroke prevention in atrial fibrillation.
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Supports LAA closure in anticoagulation-intolerant AF; leaves open comparative long-term data for epicardial devices.
Cardioembolic stroke is a major cause of morbidity and mortality in patients with atrial fibrillation (AF). The left atrial appendage (LAA) is the prominent source of clot formation. While systemic anticoagulation is the current standard of care, anticoagulants carry many contraindications and possible complications. Techniques for elimination of the LAA are in various stages of development and early clinical use. In the coming years, accumulating data will help guide the management of AF patients at risk of bleeding as well as potentially become first-line therapy to reduce the risk of thromboembolic stroke. The purpose of this article is to review current endovascular and epicardial catheter-based LAA occlusion devices and the clinical data supporting their use.
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Kapur et al. (2011) conducted a review in Atrial fibrillation. Percutaneous endovascular and epicardial left atrial appendage (LAA) occlusion devices (PLAATO, WATCHMAN, Amplatzer Cardiac Plug, LARIAT, Aegis) vs. Systemic oral anticoagulation (e.g., warfarin) or antiplatelet therapy was evaluated.
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