Device-related thrombus after LAAO tied to ischemic events
Device-related thrombus (DRT) following left atrial appendage occlusion (LAAO) is associated with increased rates of ischemic events, according to new data published in the Journal of the American College of Cardiology.
Trevor Simard, MD, a cardiologist at the Mayo Clinic School of Medicine, and colleagues, examined data from a study that described the management patterns and mid-term outcomes of DRT and assessed patient and procedural predictors of DRT.
In the study that included 711 patients, (237 with and 474 without DRT), DRTs were diagnosed in 24.9% of patients after 45 days, 38.8% after 180 days, 16% after a year and 20.3% after more than a year. After the last known follow-up, 25.3% of patients had DRT.
DRT was associated with a greater risk of the composite endpoint of death, ischemic stroke, or systemic embolization driven by ischemic stroke, according to the authors.
Also, turning to discharge medications after LAAO had no effect on the presence of DRT.
Simard et al. also reported that a multivariable analysis identified 5 DRT risk factors: hypercoagulability disorder, pericardial effusion, renal insufficiency, an implantation depth greater than 10 mm from the pulmonary vein limbus, and non-paroxysmal atrial fibrillation.
“Patient and procedural risk factors can predict DRT, aiding in risk stratification and optimization of procedural techniques and postprocedural management,” they wrote.
Read the full study here.