Key result
LAAO permits DOAC discontinuation and reduces tumor bleeding to facilitate successful ESD without complications.
Why the study?
Does left atrial appendage occlusion permit DOAC discontinuation and reduce bleeding risk in a patient with chronic atrial fibrillation undergoing endoscopic submucosal dissection?
Case Report (n=1)
Does left atrial appendage occlusion permit DOAC discontinuation and reduce bleeding risk in a patient with chronic atrial fibrillation undergoing endoscopic submucosal dissection?
Left atrial appendage occlusion may be a viable strategy to manage bleeding risk by enabling DOAC discontinuation in patients with atrial fibrillation requiring high-bleeding-risk endoscopic procedures.
LAAO may enable DOAC cessation before high-bleeding-risk endoscopy in AF; hypothesis-generating case report requiring prospective validation.
Percutaneous left atrial appendage occlusion prevents cardiogenic embolism caused by atrial fibrillation. It involves sealing the left atrial appendage using a specific closing device to avoid long-term anticoagulation. Here, we report an 88-year-old patient with colorectal cancer scheduled for endoscopic submucosal dissection (ESD) who had tumor surface bleeding and a high procedural hemorrhagic risk. During dual therapy with an antiplatelet agent and a direct oral anticoagulant (DOAC), left atrial appendage occlusion permitted DOAC discontinuation and reduced tumor bleeding. ESD was subsequently performed successfully and without complications under antiplatelet monotherapy.
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Yanase et al. (2026) conducted a case report in Colorectal cancer and chronic atrial fibrillation (n=1). Left atrial appendage occlusion was evaluated. Left atrial appendage occlusion permitted DOAC discontinuation and reduced tumor bleeding, allowing successful endoscopic submucosal dissection without complications.
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