Background: Left atrial appendage (LAA) closure is primarily performed in patients who have contraindications to anticoagulants. However, anticoagulants are recommended for the first few weeks after LAA closure to prevent the device related thrombus. Purpose of this study was to evaluate if short term use of anticoagulant is safe and effective after LAA closure in patients with a history of intracranial hemorrhage. Methods: It is a retrospective observational study done at a single center. Baseline characteristics, perioperative, and postoperative complications of patients with a history of intracranial hemorrhage and Watchman device implant were analyzed, and patients were followed for a mean follow-up of 27 months. Results: LAA closure was performed in 16 patients using the Watchman device (Boston Scientific, MA). Mean age was 74.6 ± 5.8 years, median CHA2DS2-VASc score was 4.5 (interquartile range of 3), median HAS-BLED score was 4 (interquartile range of 1). Patients received aspirin 81 mg with oral anticoagulant for 45 days, dual antiplatelet therapy for 4.5 months, and thereafter aspirin indefinitely. No perioperative and postoperative complications were noted. Conclusion: Based on our single center experience, we conclude that antithrombotic drugs in the short term appear safe and effective in selected patients after LAA closure in patients with previous intracranial hemorrhage.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Stroke and Cerebrovascular Diseases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Atrial fibrillation: the current epidemic.J Geriatric Cardiol. 2017; : 195-203
- How I use anticoagulation in atrial fibrillation.Blood. 2016; 128: 2891-2898
- Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation.Ann Thoracic Surg. 1996; : 755-759
- Management of stroke risk in atrial fibrillation patients with bleeding on oral anticoagulation therapy-role of left atrial appendage closure, octreotide and more.J Atr Fibrillation. 2017; 10
- Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation.Circulation. 2013; 127
- Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy.J Am Coll Cardiol. 2014; 64: 1-12
- Boston Scientific Receives FDA Approval for WATCHMAN™ Left Atrial Appendage Closure Device.Boston Scientific, MARLBOROUGH2015
- Evaluating real-world clinical outcomes in atrial fibrillation patients receiving the WATCHMAN left atrial appendage closure technology.Circulation. 2019; 12https://doi.org/10.1161/CIRCEP.118.006841
- Left atrial appendage closure device implantation in patients with prior intracranial hemorrhage.Heart Rhythm. 2019; : 663-668
Published online: February 11, 2020
Accepted: January 17, 2020
Received in revised form: December 20, 2019
Received: October 12, 2019
© 2020 Elsevier Inc. All rights reserved.