Tanaka Takamasa, Kawai Kenji, Ellis Christopher R, Srivastava Mukta, Kawakami Rika, Konishi Takao, Shiraki Tatsuya, Sekimoto Teruo, Virmani Renu, Finn Aloke V
CVPath Institute, Gaithersburg, MD 20878, USA.
Vanderbilt Heart and Vascular Institute, Nashville, TN 37232, USA.
Future Cardiol. 2024;20(7-8):343-358. doi: 10.1080/14796678.2024.2363063. Epub 2024 Jul 1.
Oral anticoagulation therapy (OAC) is a mainstay for mitigating stroke and other embolic events in patients with atrial fibrillation (AF). Despite the demonstrated efficacy of OAC in reducing events, many patients are unable to tolerate OAC due to bleeding risks. Left atrial appendage occlusion (LAAO) devices were developed as implantable technologies to moderate stroke risk in patients with intolerance to OAC. Despite clinical data supporting near-comparable protection against thromboembolic events with OAC, device-related thrombus formation has emerged as a critical complication following LAAO that remains a potential limitation to the safety and efficacy of LAAO. Improved biocompatibility of LAAO devices with fluoropolymers, a well-established stent-coating technology used to reduce thrombus formation and promote endothelialization, may optimize outcomes after LAAO.
口服抗凝治疗（OAC）是减轻心房颤动（AF）患者中风和其他栓塞事件的主要手段。尽管OAC在减少事件方面已显示出疗效，但由于出血风险，许多患者无法耐受OAC。左心耳封堵（LAAO）装置作为可植入技术被开发出来，用于降低不耐受OAC患者的中风风险。尽管临床数据支持LAAO在预防血栓栓塞事件方面与OAC具有近乎相当的保护作用，但装置相关血栓形成已成为LAAO后的关键并发症，仍然是LAAO安全性和有效性的潜在限制。使用成熟的支架涂层技术氟聚合物提高LAAO装置的生物相容性，可减少血栓形成并促进内皮化，可能会优化LAAO后的治疗效果。
