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Forschungsdatenbank PMU-SQQUID

Peri-procedural silent cerebral infarcts after left atrial appendage occlusion.
Laible, M; Mohlenbruch, M; Horstmann, S; Pfaff, J; Geis, NA; Pleger, S; Schuler, S; Rizos, T; Bendszus, M; Veltkamp, R
Eur J Neurol. 2017; 24(1):53-57
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Pfaff Johannes

Abstract

Background and purpose: To determine the rate of peri-interventional silent brain infarcts after left atrial appendage occlusion (LAAO). Methods: In this prospective, uncontrolled single-center pilot study, consecutive patients with atrial fibrillation undergoing LAAO between July 2013 and January 2016 were included. The Amplatzer Cardiac Plug, WATCHMAN or Amulet device was used. A neurological examination and cranial magnetic resonance imaging (MRI) were performed within 48 h before and after the procedure. MRI was evaluated for new diffusion-weighted imaging (DWI) hyperintensities, cerebral microbleeds (CMBs) and white-matter lesions (WMLs). Results: Left atrial appendage occlusion was performed in 21 patients (mean age, 73.2 +/- 9.5 years). Main reasons for LAAO were previous intracerebral hemorrhage (n = 11) and major systemic bleeding (n = 6). No clinically overt stroke occurred peri-interventionally. After the intervention, one patient had a small cerebellar hyperintensity on DWI (4.8%; 95% confidence interval, 0.0-14.3) that was not present on the MRI 1 day before the procedure. Among 11 patients with available MRI just before LAAO, there were no significant changes in the number of CMBs and the severity of WMLs after LAAO. Conclusions: This study of peri-interventional MRI in LAAO suggests a low rate of silent peri-procedural infarcts in this elderly population. Confirmation in larger studies is needed.


Useful keywords (using NLM MeSH Indexing)

Aged

Aged, 80 and over

Atrial Appendage*

Atrial Fibrillation/complications

Atrial Fibrillation/therapy

Cerebral Hemorrhage/epidemiology

Cerebral Hemorrhage/etiology

Cerebral Infarction/epidemiology*

Cerebral Infarction/etiology*

Diffusion Magnetic Resonance Imaging

Female

Humans

Male

Middle Aged

Neurologic Examination

Pilot Projects

Prospective Studies

Stroke/epidemiology

Stroke/etiology

Therapeutic Occlusion/adverse effects*

Therapeutic Occlusion/statistics*

numerical data

Treatment Outcome

White Matter/diagnostic imaging

White Matter/pathology


Find related publications in this database (Keywords)

left atrial appendage occlusion
magnetic resonance imaging
silent brain infarction