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首页> 外文期刊>Herz >Left atrial appendage closure for stroke prevention in atrial fibrillation An update
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Left atrial appendage closure for stroke prevention in atrial fibrillation An update

机译：在心房颤动中卒中预防的左心房阑尾闭合更新

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摘要

Atrial fibrillation (AF) is one of the most frequent causes of ischemic stroke. Without treatment the annual risk of ischemic stroke is on average approximately 5-6%/year in patients with atrial fibrillation, depending on the overall cardiovascular risk profile. Oral anticoagulation with new oral anticoagulants (NOAC) or vitamin K antagonists (VKA) is recommended for patients with AF and an elevated risk for stroke (CHA(2)DS(2)-VASc score >= 1); however, severe bleeding complications are potential reasons for discontinuation of this treatment. Overall, up to 30 & x202f;% of the patients with AF remain without effective thromboembolism prophylaxis. Left atrial appendage (LAA) closure represents an alternative to pharmaceutical stroke prevention. Catheter-based and surgical LAA closure techniques are available. For catheter-based procedures with closure systems, high implantation success rates and relatively low periprocedural complication rates have been observed in recent registry studies. The reason for the restrained recommendation in the European guidelines is the as yet limited experience from large randomized studies.
机译：心房颤动（AF）是缺血性卒中最常见的原因之一。没有治疗，缺血性脑卒中的年风险平均每年约为5-6％，根据整体心血管风险概况。用新口腔抗凝血剂（NOAC）或维生素K拮抗剂（VKA）的口服抗凝，适用于AF的患者和中风的升高风险（CHA（2）DS（2）-vasc评分> = 1）;然而，严重的出血并发症是停止这种治疗的潜在原因。总的来说，高达30＆X202F; AF患者的百分比仍然没有有效的血栓栓塞预防。左心房附属（LAA）封闭代表了药物中风预防的替代品。可提供基于导管和外科手术的LAA闭合技术。对于具有闭合系统的基于导管的程序，在最近的登记研究中已经观察到高植入成功率和相对低的跨越式并发症率。欧洲准则中受限制建议的原因是大型随机研究的尚未有限的经验。

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