View in EDS HTML Full Text PDF Full Text

Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.

Saved in:
Bibliographic Details
Title: Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.
Authors: Galea, Roberto (AUTHOR), Casu, Gavino (AUTHOR), Bini, Tommaso (AUTHOR), Laconi, Angelo (AUTHOR), Merella, Pier Luigi (AUTHOR), Chalkou, Konstantina (AUTHOR), Preda, Alberto (AUTHOR), Cerciello, Marco (AUTHOR), D'Angelo, Giuseppe (AUTHOR), Bella, Paolo della (AUTHOR), Mazzone, Patrizio (AUTHOR), Auer, Elias (AUTHOR), Gasys, Antanas (AUTHOR), Seiffge, David Julian (AUTHOR), Fischer, Urs (AUTHOR), Räber, Lorenz (AUTHOR)
Source: European Journal of Neurology. Sep2025, Vol. 32 Issue 9, p1-8. 8p.
Subjects: Left atrial appendage closure, Atrial fibrillation, Anticoagulants, Secondary prevention, Surgical complications, Treatment effectiveness, Ischemic stroke
Abstract: Background: Patients with non‐valvular atrial fibrillation (AF) who experience an ischemic stroke despite oral anticoagulation (OAC) are at particularly high risk of recurrence, with a reported annualized ischemic stroke rate of 5.3%–8.9%. The optimal strategy for secondary prevention in these patients remains unknown. Methods: We reviewed all percutaneous left atrial appendage closures (LAAC) attempted in AF patients experiencing an ischemic stroke under OAC and who were prospectively collected in four European centers. All index strokes were categorized by an experienced neurologist to exclude patients with non‐cardioembolic etiology or insufficient OAC. The primary endpoint was a recurrent ischemic stroke at 2 years after the procedure. Secondary endpoints included procedure‐related complications and 2‐year death. Results: Of 2234 patients submitted to LAAC procedure, 95 had a cardioembolic breakthrough stroke. LAAC procedures were performed at a mean of 4 months after the breakthrough stroke. The main antithrombotic therapy at discharge (83%) and at the latest follow‐up (79%) consisted of OAC. At the median follow‐up of 713 days, the primary endpoint occurred in 4 patients (4%). Procedure‐related complications were rare (1%) whereas death occurred in 5% of patients. Conclusion: LAAC procedures were safe and feasible in patients with cardioembolic breakthrough stroke. Recurrent stroke rates were lower than those reported in previous studies with OAC continuation after breakthrough stroke, suggesting a potential additive protection by LAAC on top of OAC. Results from ongoing randomized trials are required to validate our findings. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 188312122
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Galea%2C+Roberto%22">Galea, Roberto</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Casu%2C+Gavino%22">Casu, Gavino</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bini%2C+Tommaso%22">Bini, Tommaso</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Laconi%2C+Angelo%22">Laconi, Angelo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Merella%2C+Pier+Luigi%22">Merella, Pier Luigi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chalkou%2C+Konstantina%22">Chalkou, Konstantina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Preda%2C+Alberto%22">Preda, Alberto</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cerciello%2C+Marco%22">Cerciello, Marco</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22D'Angelo%2C+Giuseppe%22">D'Angelo, Giuseppe</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bella%2C+Paolo+della%22">Bella, Paolo della</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mazzone%2C+Patrizio%22">Mazzone, Patrizio</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Auer%2C+Elias%22">Auer, Elias</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gasys%2C+Antanas%22">Gasys, Antanas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Seiffge%2C+David+Julian%22">Seiffge, David Julian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fischer%2C+Urs%22">Fischer, Urs</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Räber%2C+Lorenz%22">Räber, Lorenz</searchLink> (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Sep2025, Vol. 32 Issue 9, p1-8. 8p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Left+atrial+appendage+closure%22">Left atrial appendage closure</searchLink><br /><searchLink fieldCode="DE" term="%22Atrial+fibrillation%22">Atrial fibrillation</searchLink><br /><searchLink fieldCode="DE" term="%22Anticoagulants%22">Anticoagulants</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+prevention%22">Secondary prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+complications%22">Surgical complications</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Patients with non‐valvular atrial fibrillation (AF) who experience an ischemic stroke despite oral anticoagulation (OAC) are at particularly high risk of recurrence, with a reported annualized ischemic stroke rate of 5.3%–8.9%. The optimal strategy for secondary prevention in these patients remains unknown. Methods: We reviewed all percutaneous left atrial appendage closures (LAAC) attempted in AF patients experiencing an ischemic stroke under OAC and who were prospectively collected in four European centers. All index strokes were categorized by an experienced neurologist to exclude patients with non‐cardioembolic etiology or insufficient OAC. The primary endpoint was a recurrent ischemic stroke at 2 years after the procedure. Secondary endpoints included procedure‐related complications and 2‐year death. Results: Of 2234 patients submitted to LAAC procedure, 95 had a cardioembolic breakthrough stroke. LAAC procedures were performed at a mean of 4 months after the breakthrough stroke. The main antithrombotic therapy at discharge (83%) and at the latest follow‐up (79%) consisted of OAC. At the median follow‐up of 713 days, the primary endpoint occurred in 4 patients (4%). Procedure‐related complications were rare (1%) whereas death occurred in 5% of patients. Conclusion: LAAC procedures were safe and feasible in patients with cardioembolic breakthrough stroke. Recurrent stroke rates were lower than those reported in previous studies with OAC continuation after breakthrough stroke, suggesting a potential additive protection by LAAC on top of OAC. Results from ongoing randomized trials are required to validate our findings. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=188312122
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/ene.70365
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 1
    Subjects:
      – SubjectFull: Left atrial appendage closure
        Type: general
      – SubjectFull: Atrial fibrillation
        Type: general
      – SubjectFull: Anticoagulants
        Type: general
      – SubjectFull: Secondary prevention
        Type: general
      – SubjectFull: Surgical complications
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Ischemic stroke
        Type: general
    Titles:
      – TitleFull: Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Galea, Roberto
      – PersonEntity:
          Name:
            NameFull: Casu, Gavino
      – PersonEntity:
          Name:
            NameFull: Bini, Tommaso
      – PersonEntity:
          Name:
            NameFull: Laconi, Angelo
      – PersonEntity:
          Name:
            NameFull: Merella, Pier Luigi
      – PersonEntity:
          Name:
            NameFull: Chalkou, Konstantina
      – PersonEntity:
          Name:
            NameFull: Preda, Alberto
      – PersonEntity:
          Name:
            NameFull: Cerciello, Marco
      – PersonEntity:
          Name:
            NameFull: D'Angelo, Giuseppe
      – PersonEntity:
          Name:
            NameFull: Bella, Paolo della
      – PersonEntity:
          Name:
            NameFull: Mazzone, Patrizio
      – PersonEntity:
          Name:
            NameFull: Auer, Elias
      – PersonEntity:
          Name:
            NameFull: Gasys, Antanas
      – PersonEntity:
          Name:
            NameFull: Seiffge, David Julian
      – PersonEntity:
          Name:
            NameFull: Fischer, Urs
      – PersonEntity:
          Name:
            NameFull: Räber, Lorenz
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Text: Sep2025
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 13515101
          Numbering:
            – Type: volume
              Value: 32
            – Type: issue
              Value: 9
          Titles:
            – TitleFull: European Journal of Neurology
              Type: main
ResultId 1