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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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[Interventional prevention of ischemic stroke]

P Kamtchueng1, E Teiger

  • 1Unité de cathétérisme cardiaque, service d'explorations fonctionnelles, centre hospitalier Henri-Mondor, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France.

Annales De Cardiologie Et D'Angeiologie
|November 9, 2013
PubMed

Insights

Stroke prevention in atrial fibrillation is crucial. Left atrial appendage closure offers a promising alternative to anticoagulation for patients at high risk of stroke or bleeding.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Context:

  • Stroke is a leading cause of disability and death, necessitating effective prevention strategies.
  • Atrial fibrillation significantly increases stroke risk, requiring careful patient management.
  • Current treatments like anticoagulation have limitations for certain patient groups.

Purpose:

  • To review the role of left atrial appendage percutaneous closure as an alternative stroke prevention strategy.
  • To evaluate the feasibility, effectiveness, and safety of devices like WATCHMAN(©), PLAATO, and AmplatzerCardiacPlug™.
  • To discuss the implications of studies like PROTECT-AF and ongoing clinical evaluations.

Summary:

  • Left atrial appendage (LAA) percutaneous closure is an emerging interventional treatment for stroke prevention in atrial fibrillation.
  • Devices such as WATCHMAN(©) have demonstrated non-inferiority to warfarin in preventing thromboembolic events.
  • Risk stratification using CHA(2)DS(2)VASc and HASBLED scores guides treatment decisions.

Impact:

  • Provides a potential alternative for patients unsuitable for or experiencing complications with anticoagulation.
  • Offers a new therapeutic avenue to reduce the burden of stroke in atrial fibrillation patients.
  • Highlights the need for further research to define optimal patient selection for LAA closure.

Keywords:
Accident vasculaire cérébralAtrial fibrillationAuricule gaucheBleeding riskFermeture percutanéeFibrillation auriculaireLeft atrium appendageOral anticoagulant therapyPercutaneous closureRisque hémorragiqueStrokeTraitement anticoagulant

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