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Peri-procedural silent cerebral infarcts after left atrial appendage occlusion.
Laible, M; Möhlenbruch, M; Horstmann, S; Pfaff, J; Geis, N A; Pleger, S; Schüler, S; Rizos, T; Bendszus, M; Veltkamp, R.
Afiliación
  • Laible M; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
  • Möhlenbruch M; Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Horstmann S; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
  • Pfaff J; Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Geis NA; Department of Internal Medicine III, Heidelberg University Hospital, Heidelberg, Germany.
  • Pleger S; Department of Internal Medicine III, Heidelberg University Hospital, Heidelberg, Germany.
  • Schüler S; Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
  • Rizos T; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
  • Bendszus M; Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Veltkamp R; Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Eur J Neurol ; 24(1): 53-57, 2017 01.
Article en En | MEDLINE | ID: mdl-27647674
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.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infarto Cerebral / Apéndice Atrial / Oclusión Terapéutica Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infarto Cerebral / Apéndice Atrial / Oclusión Terapéutica Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania