Related Experiment Video
Updated: Jan 6, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Temporal Trends in Device-related Thrombosis Following Left Atrial Appendage Occlusion: A Systematic Review and
Tannaz Rajabi1, Wei Li1, Seyed Ali Nabipoorashrafi2
1University of Rochester School of Medicine and Dentistry, Rochester, NY.
None:
Purpose To perform a systematic review and meta-analysis to evaluate longitudinal trends in the incidence of device-related thrombosis (DRT) following left atrial appendage occlusion (LAAO), with the aim of informing future postprocedural surveillance schedules. Materials and Methods PubMed, Embase, and Cochrane Library databases were retrospectively searched up to May 2023 for clinical trials and observational studies with at least 20 adults who underwent LAAO and had a DRT detected with CT or transesophageal echocardiography. DRT events were stratified by time since procedure, and cumulative incidence rates were calculated using random-effects and mixed-effects models. Quality assessments were completed using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results A review of 2181 records resulted in the inclusion of 96 articles, encompassing 18 024 patients (mean ages ranged from 63.5 years ± 7.3 [SD] to 92.9 years ± 2.8; 61.7% male [11 121 of 18 024]). The total DRT incidence was 2.65% (478 of 18 024; range, 0%-17.5%). The mean cumulative DRT incidence rates using the random-effects model were 0.83% (n = 996; 95% CI: 0.23, 2.98; I2 = 0.0%) at 30 days, 1.24% (n = 10 909; 95% CI: 0.90, 1.70; I2 = 37.3%) at 45 days, 2.14% (n = 4559; 95% CI: 1.41, 3.25; I2 = 36.9%) at 90 days, 2.06% (n = 8088; 95% CI: 1.45, 2.92; I2 = 62.5%) at 180 days, and 2.9% (n = 7346; 95% CI: 2.07, 4.06; I2 = 70.6%) beyond 180 days. Similar results were achieved with the mixed-effects model. Conclusion DRT incidence changed over time following LAAO. The greatest rise in the incidence occurred during the first 90 days after the procedure, although the cumulative rates continued to increase beyond 180 days. Keywords: Device-related Thrombosis, Left Atrial Appendage Occlusion, Meta-analysis, Transesophageal Echocardiography, CT Supplemental material is available for this article. © RSNA, 2025.
