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Updated: May 6, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Ischemic stroke associated with high-grade pedunculated device-related thrombosis following left atrial appendage
Ryuki Chatani1, Shunsuke Kubo1, Hiroshi Tasaka1
1Department of Cardiovascular Medicine Kurashiki Central Hospital Kurashiki Japan.
Insights
High-grade thrombosis after left atrial appendage closure (LAAC) can cause ischemic stroke. Continuing oral anticoagulations (OACs), even at half dose, may prevent future thromboembolic events in high-risk patients.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation for stroke prevention in atrial fibrillation.
- Device-related thrombosis is a known complication after LAAC.
- Discontinuation of oral anticoagulations (OACs) after LAAC may increase thromboembolic risk.
Purpose of the Study:
- To report a case of ischemic stroke secondary to device-related thrombosis after LAAC and OAC discontinuation.
- To discuss the potential benefit of continuing OACs in high-risk patients post-LAAC.
Main Methods:
- Case report presentation.
- Review of relevant literature on LAAC and thromboembolic complications.
Main Results:
- A patient developed a high-grade, device-related pedunculated thrombosis leading to ischemic stroke after LAAC and stopping OACs.
- This highlights a potential risk associated with OAC cessation post-LAAC.
Conclusions:
- Patients undergoing LAAC, particularly those at high risk for thromboembolism, may benefit from continued OAC therapy.
- Consideration of half-dose direct oral anticoagulations post-LAAC could be a strategy to prevent recurrent events.
Abstract:
We have seen ischemic stroke associated with a high-grade device-related pedunculated thrombosis after left atrial appendage closure (LAAC) after discontinuation of oral anticoagulations (OACs). Continuation of OACs, including half-dose direct oral anticoagulations after LAAC, may be a better option for patients at high risk of thromboembolism to prevent further thromboembolic events.
