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Review
. 2021 Dec 8;3(2):396-402.
doi: 10.34067/KID.0004082021. eCollection 2022 Feb 24.

Left Atrial Appendage Closure: An Alternative to Anticoagulation for Stroke Prevention in Patients with Kidney Disease

Srikanth Vallurupalli  1   2 , Tanya Sharma  1 , Subhi Al'Aref  1 , Subodh R Devabhaktuni  1 , Gaurav Dhar  1   2
Affiliations
Review

Left Atrial Appendage Closure: An Alternative to Anticoagulation for Stroke Prevention in Patients with Kidney Disease

Srikanth Vallurupalli et al. Kidney360. .

Abstract

Anticoagulation to reduce thromboembolic stroke risk due to nonvalvular atrial fibrillation in ESKD is associated with increased bleeding. There is an existing debate in ESKD centers around the pros and cons of anticoagulation. We propose percutaneous left atrial appendage occlusion as a third alternative to balance thrombosis and bleeding risks in this high-risk population.

Keywords: anticoagulants; atrial fibrillation; blood coagulation; chronic kidney disease; left atrial appendage occlusion; stroke.

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Conflict of interest statement

S. Al’Aref reports the research funding (NIH 2R01 HL12766105 and NIH 1R21EB030654), and honoraria in the form of royalty fees from Elsevier. S.R. Devabhaktuni reports being on the editorial board for the Journal of Clinical Cardiology and Cardiovascular Therapy, Cardiology Cases and Systematic Reviews, International Journal of Cardiac Science and Research, and The Journal of Innovations in Cardiac Rhythm Management. G. Dhar reports consultancy agreements with Abbott Vascular, Boston Sci, Edwards Lifesciences, and Medtronic; research funding from Boston Sci; and is a member of Boston Sci Advisory Board. The remaining authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
The two left atrial appendage occlusion devices approved by the Food and Drug Administration in the United States. Left: the WATCHMAN FLX (Boston Scientific, Marlborough, MA). Right: the Amplatzer Amulet (Abbott, Chicago, IL).
See this image and copyright information in PMC

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