Goette A
Medizinische Klinik II, St. Vincenz-Krankenhaus GmbH, Paderborn, Deutschland.
Nervenarzt. 2011 Feb;82(2):172, 174-6, 178-9. doi: 10.1007/s00115-010-3113-6.
Atrial fibrillation causes 15-20% of ischemic strokes and the overall risk of stroke in patients with non-valvular atrial fibrillation is about 5% per year globally. Warfarin has long been the cornerstone for decreasing risks of stroke in patients with atrial fibrillation and its efficacy has been well established. However, 14-44% of patients with atrial fibrillation who are at risk of stroke are ineligible for anticoagulation therapy, mostly owing to the risks of major bleeding and falls. Occlusion of the left atrial appendage (LAA) appears to be an interesting new tool to prevent thromboembolic events in selected cases. In addition to surgical techniques, percutaneous transcatheter approaches have been introduced to occlude the LAA. Recent results indicate non-inferiority of mechanical occlusion of the LAA in comparison to warfarin therapy.
心房颤动导致15% - 20%的缺血性中风，全球非瓣膜性心房颤动患者的总体中风风险约为每年5%。长期以来，华法林一直是降低心房颤动患者中风风险的基石，其疗效已得到充分证实。然而，14% - 44%有中风风险的心房颤动患者不符合抗凝治疗条件，主要是由于大出血和跌倒的风险。在某些特定情况下，封堵左心耳（LAA）似乎是预防血栓栓塞事件的一种有趣的新方法。除了外科技术外，经皮导管介入方法也已被用于封堵LAA。最近的结果表明，与华法林治疗相比，LAA机械封堵并不逊色。
