Observational studyHeart (British Cardiac Society)2022
Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure.
Observational study in Heart (British Cardiac Society), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure.BMC cardiovascular disorders · 2024Pooled it
- Left atrial appendage thrombus formation, potential of resolution and association with prognosis in a large real-world cohort.Scientific reports · 2023Trial
- Long-Term Clinical Outcomes of Left Atrial Appendage Closure in Patients with Left Atrial Appendage Thrombus.Journal of clinical medicine · 2025Article
- Article
- Management of left atrial appendage thrombus before percutaneous closure: Case report.HeartRhythm case reports · 2025Article
- Cardiomyopathy and thrombogenesis in cats through left atrial morphological and fluid dynamics analysis.Scientific reports · 2025Article
- The impact of contrast retention on thrombus formation risks in patients with atrial fibrillation: A numerical study.Heliyon · 2024Article
- Percutaneous Left Atrial Appendage Occlusion-Current Evidence and Future Directions.Journal of clinical medicine · 2023Review
- Diagnostic and therapeutic pathways for the malignant left atrial appendage: European Heart Rhythm Association physician survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Left Atrial Appendage Occlusion in Patients with Failure of Antithrombotic Therapy: Good Vibes from Early Studies.Journal of clinical medicine · 2023Article
- Left atrial appendage occlusion after thromboembolic events or left atrial appendage sludge during anticoagulation therapy: Is two better than one? Real-world experience from a tertiary care hospital.Journal of arrhythmia · 2023Article
- Percutaneous left atrial appendage closure: beyond the classic indications.AsiaIntervention · 2023Review
- Percutaneous Left Atrial Appendage Closure with the LAmbre Device Protected by a Cerebral Protection System in a 76-Year-Old Man with Persistent Left Atrial Appendage Thrombus.The American journal of case reports · 2022Article
- Outcomes of cardiac surgery with left atrial appendage occlusion versus no Occlusion, direct oral Anticoagulants, and vitamin K Antagonists: A systematic review with Meta-analysis.International journal of cardiology. Heart & vasculature · 2022Review
- Percutaneous left atrial appendage closure using the LAmbre device in patients with atrial fibrillation and left atrial appendage thrombus.Frontiers in cardiovascular medicine · 2022Article
- SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure.Journal of the Society for Cardiovascular Angiography & InterventionsArticle
Corrections and comments
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Authors and funding
39 authors at 18 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLeft atrial appendage (LAA) thrombus has heretofore been considered a contraindication to percutaneous LAA closure (LAAC). Data regarding its management are very limited. The aim of this study was to analyse the medical and invasive treatment of patients referred for LAAC in the presence of LAA thrombus.
methodsThis multicentre observational registry included 126 consecutive patients referred for LAAC with LAA thrombus on preprocedural imaging. Treatment strategies included intensification of antithrombotic therapy (IAT) or direct LAAC. The primary and secondary endpoints were a composite of bleeding, stroke and death at 18 months, and procedural success, respectively.
resultsIAT was the preferred strategy in 57.9% of patients, with total thrombus resolution observed in 60.3% and 75.3% after initial and subsequent IAT, respectively. Bleeding complications and stroke during IAT occurred in 9.6% and 2.9%, respectively, compared with 3.8% bleeding and no embolic events in the direct LAAC group before the procedure. Procedural success was 90.5% (96.2% vs 86.3% in direct LAAC and IAT group, respectively, p=0.072), without cases of in-hospital thromboembolic complications. The primary endpoint occurred in 29.3% and device-related thrombosis was found in 12.8%, without significant difference according to treatment strategy. Bleeding complications at 18 months occurred in 22.5% vs 10.5% in the IAT and direct LAAC group, respectively (p=0.102).
conclusionIn the presence of LAA thrombus, IAT was the initial management strategy in half of our cohort, with initial thrombus resolution in 60% of these, but with a relatively high bleeding rate (~10%). Direct LAAC was feasible, with high procedural success and absence of periprocedural embolic complications. However, a high rate of device-related thrombosis was detected during follow-up.
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