Efficient Removal of Nascent Left Atrial Appendage Thrombus to Facilitate Left Atrial Appendage Closure.

ABSTRACT:

Background

Left atrial appendage (LAA) thrombus often precludes immediate closure owing to embolic risk, complicating care for high-risk patients needing stroke prevention.

Case summary

A 78-year-old woman with atrial fibrillation and recent intracranial hemorrhage was referred for left atrial appendage closure (LAAC). Imaging revealed a nascent thrombus at the LAA ostium. Given her high bleeding risk, thrombus aspiration was attempted. Using a deflectable delivery sheath and computer-assisted vacuum catheter, the thrombus was successfully removed en face without embolization. A 27-mm LAAC device was deployed, with excellent results. She was discharged on low-dose apixaban (2.5 mg bid) and remained event-free at 45 days.

Discussion

This case highlights a feasible, min

SUBMITTER: Arkles J 

PROVIDER: S-EPMC12789754 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature