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Related Concept Videos

Disorders of Hemostasis01:24

Disorders of Hemostasis

680
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
680
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

593
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
593

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Related Experiment Video

Updated: May 27, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Left atrial appendage occlusion: behind the bleeding risk.

Giovanni Lorenzoni1, Pierluigi Merella1, Gavino Casu1

  • 1S.C. Cardiologia Clinica e Interventistica, A.O.U. Sassari, Sassari, Italy.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|February 21, 2025
PubMed
Summary

Atrial fibrillation increases stroke risk. Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulants for stroke prevention in non-valvular atrial fibrillation (NVAF), even in patients with

Keywords:
Ischemic strokeLeft atrial appendage occlusionOral anticoagulant therapy

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Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) is a prevalent arrhythmia linked to a higher risk of embolic stroke.
  • Oral anticoagulant therapy (OAT) is the primary strategy for preventing cerebral embolic events in AF patients.
  • Non-valvular atrial fibrillation (NVAF) patients may experience ischemic strokes despite adequate OAT.

Purpose of the Study:

  • To explore the role of Left Atrial Appendage Occlusion (LAAO) as a secondary prevention strategy for ischemic strokes in NVAF patients.
  • To discuss the challenges and considerations for LAAO in patients with 'resistant strokes' despite OAT.

Main Methods:

  • Review of clinical trials comparing LAAO and OAT for stroke prevention in NVAF.
  • Analysis of physiopathological theories for stroke occurrence in NVAF patients on OAT.
  • Evaluation of LAAO as a therapeutic option for secondary stroke prevention.

Main Results:

  • LAAO has shown non-inferiority to OAT in preventing stroke in NVAF patients.
  • The exact reasons for stroke occurrence in NVAF patients on OAT ('resistant strokes') are not fully understood.
  • LAAO is a viable option requiring careful patient selection and planning.

Conclusions:

  • LAAO is a demonstrated alternative to OAT for stroke prevention in NVAF.
  • Further research is needed to elucidate the mechanisms of 'resistant strokes'.
  • LAAO can be successfully performed in selected NVAF patients for stroke risk reduction.