Patti Giuseppe, Cavallari Ilaria
Dipartimento di Medicina Clinica, Sanità Pubblica, Scienza della Vita e dell'Ambiente, Università degli Studi, L'Aquila - Dipartimento di Malattie dell'Apparato Cardiovascolare, Policlinico Campus Bio-Medico, Roma.
Dipartimento di Malattie dell'Apparato Cardiovascolare, Policlinico Campus Bio-Medico, Roma.
G Ital Cardiol (Rome). 2019 Mar;20(3 Suppl 1):23S-27S. doi: 10.1714/3121.31038.
Percutaneous left atrial appendage occlusion is a novel therapeutic option for stroke prevention in patients with atrial fibrillation and contraindication to oral anticoagulant therapy. However, after left atrial appendage occlusion with the most commonly used devices, a short period of antithrombotic therapy is indicated to allow complete endothelialization of the device and to prevent device thrombosis. Post-procedure antithrombotic strategies are often performed empirically, because of the lack of clear evidence. The present article summarizes the main evidence and recommendations of the scientific societies about antithrombotic therapy after percutaneous left atrial appendage occlusion, suggesting individualized antithrombotic strategies based on the patient's hemorrhagic and thrombotic risk.
经皮左心耳封堵术是房颤患者预防卒中的一种新型治疗选择,适用于口服抗凝治疗有禁忌的患者。然而,使用最常用的器械进行左心耳封堵后,需要进行短期抗栓治疗,以促进器械表面完全内皮化并预防器械血栓形成。由于缺乏明确证据,术后抗栓策略通常是经验性的。本文总结了各科学学会关于经皮左心耳封堵术后抗栓治疗的主要证据和建议,提出基于患者出血和血栓形成风险的个体化抗栓策略。