Key result
Aortic stent grafting and thrombectomy successfully rescue acute aortoiliac occlusion from embolized Watchman device perforation.
Why the study?
Aortic embolization of left atrial appendage occlusion devices is a rare cause of acute aortoiliac occlusion with limited published experience.
Case Report (n=1)
Highlights a rare, severe complication of left atrial appendage occlusion device embolization causing acute aortoiliac occlusion and resulting in aortic perforation during attempted retrieval.
Alerts clinicians to consider embolization in post-Watchman neurologic decline; extends sparse Level 5 experience on emergent aortoiliac management.
Aortic embolization of left atrial appendage occlusion devices is a rare cause of acute aortoiliac occlusion with limited published experience. We report an 86-year-old man who developed progressive bilateral lower extremity neurologic symptoms after uncomplicated Watchman implantation. Initial evaluation focused on a neurologic etiology until vascular imaging demonstrated device embolization to the distal infrarenal aorta with acute aortoiliac and left femoropopliteal occlusion. Emergent thrombectomy restored perfusion, but attempted device retrieval resulted in aortic perforation requiring endovascular exclusion with covered aortic stent grafts. Despite successful revascularization and limb salvage, significant neurologic deficits persisted at discharge.
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Wenke et al. (2026) conducted a case report in Acute aortoiliac occlusion caused by Watchman left atrial appendage occlusion device embolization (n=1). Emergent thrombectomy, attempted device retrieval, and endovascular exclusion with covered aortic stent grafts was evaluated on Revascularization, limb salvage, and neurologic recovery at discharge. Watchman device embolization in an 86-year-old man (n=1) caused acute aortoiliac occlusion managed with thrombectomy and aortic stent grafting after retrieval-induced perforation.
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