Vol 46, No 1 (2012)

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Percutaneous closure of the left atrial appendage to prevent ischaemic stroke in patients with atrial fibrillation who require but have contraindications to oral anticoagulation

Przemysław Węglarz1, Tomasz Bochenek1, Maciej Świat2, Ewa Konarska-Kuszewska1, Wojciech Wróbel1, Bogusława Czyrnik3, Katarzyna Spisak-Borowska4, Grzegorz Opala2, Maria Trusz-Gluza1
DOI: 10.5114/ninp.2012.27178
Neurol Neurochir Pol 2012;46(1):87-91.

Abstract

Atrial fibrillation (AF) is associated with a five-fold increased risk for stroke due to cardioembolic events. Most strokes in patients with AF arise from thrombus formation in the left atrial appendage (LAA). Oral anticoagulation is a standard treatment of AF patients with high risk of stroke. However, the main drawbacks of oral anticoagulation are high risk of major bleeding and imperfect effectiveness dependent on a very narrow therapeutic range. In this article, based on two case reports, we describe a method of percutaneous closure of the LAA. We discuss indications, describe the procedure and mention possible complications. LAA closure seems to be a promising tool to prevent AF-related strokes in a selected group of patients.

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Neurologia i Neurochirurgia Polska