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Role of Endovascular Closure of the Left Atrial Appendage in Stroke Prevention for Atrial Fibrillation

  • Clinical Trials and Their Interpretations (J Kizer, Section Editor)
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Abstract

The pathophysiologic mechanism of thromboembolic stroke in the setting of non-valvular atrial fibrillation (AF) resides in the left atrial appendage (LAA). In this setting, approximately 90 % of all strokes originate from this structure. Percutaneous left atrial appendage occlusion (LAAO) therapy has recently emerged as an important strategy for prevention of stroke and systemic embolism in patients with non-valvular AF. Systemic anticoagulation therapy in this AF population, while effective, is associated with a significant bleeding risk, drug compliance issues, and limited reversal strategies. In this manuscript, we will review the percutaneous devices and techniques that allow endovascular closure of the LAA, including their efficacy in stroke prevention, the safety profile of these local site-specific therapies, comparison of the multiple approaches being studied, the index patient populations involved, and long-term follow-up in comparison with systemic anticoagulation therapy. The percutaneous LAAO approach indeed represents an exciting and revolutionary advance in the field of stroke prevention in AF.

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Conflict of Interest

Jawad Kiani declares no conflict of interest.

David R. Holmes, Jr., states that both Mayo Clinic and he have a financial interest in technology related to this research. That technology has been licensed to Boston Scientific.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. The Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN, 55905, USA

    Jawad Kiani & David R. Holmes Jr

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  1. Jawad Kiani
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  2. David R. Holmes Jr
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Correspondence to David R. Holmes Jr.

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This article is part of the Topical Collection on Clinical Trials and Their Interpretations

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Kiani, J., Holmes, D.R. Role of Endovascular Closure of the Left Atrial Appendage in Stroke Prevention for Atrial Fibrillation. Curr Atheroscler Rep 17, 65 (2015). https://doi.org/10.1007/s11883-015-0542-5

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