Peri-procedural silent cerebral infarcts after left atrial appendage occlusion

• Verfasst von: Laible, Mona [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Verfasst von: Horstmann, Solveig [VerfasserIn]
• Verfasst von: Pfaff, Johannes [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Pleger, Sven Torsten [VerfasserIn]
• Verfasst von: Schüler, Svenja [VerfasserIn]
• Verfasst von: Rizos, Timolaos [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Veltkamp, Roland [VerfasserIn]
• Titel: Peri-procedural silent cerebral infarcts after left atrial appendage occlusion
• Verf.angabe: M. Laible, M. Möhlenbruch, S. Horstmann, J. Pfaff, N.A. Geis, S. Pleger, S. Schüler, T. Rizos, M. Bendszus and R. Veltkamp
• Jahr: 2017
• Umfang: 6 S.
• Fussnoten: First published: 19 September 2016 ; Gesehen am 25.10.2018
• Titel Quelle: Enthalten in: European journal of neurology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1994
• Jahr Quelle: 2017
• Band/Heft Quelle: 24(2017), 1, Seite 53-57
• ISSN Quelle: 1468-1331
• DOI: doi:10.1111/ene.13129
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: left atrial appendage occlusion
• Sach-SW: magnetic resonance imaging
• Sach-SW: silent brain infarction
• K10plus-PPN: 1582280096

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.