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Review
. 2025 Feb 27.
doi: 10.1007/s00392-025-02624-5. Online ahead of print.

Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives

Carla Rochira  1 , Alessandro Mazzapicchi  2 , Salvatore Davide Tomasello  3 , Salvatore Adriano Azzarelli  4 , Alessandro Di Giorgio  4 , Francesco Scardaci  4 , Vincenzo Argentino  4 , Francesco Amico  4
Affiliations
Review

Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives

Carla Rochira et al. Clin Res Cardiol. .

Abstract

Stroke accounts for significant morbidity and mortality worldwide. Accordingly, appropriate prevention is crucial to reduce the global burden of stroke. Percutaneous left atrial appendage closure (LAAC) is a viable approach for preventing cardioembolic stroke in patients with non-valvular atrial fibrillation who have a contraindication to long-term oral anticoagulation due to a non-reversible cause. In the last 2 decades, percutaneous LAAC has become a rapidly evolving field, with multiple devices approved or under clinical development. However, several issues remain, including limited high-quality evidence, late adverse events, and unclear post-procedural antithrombotic therapy. This review offers an up-to-date perspective on percutaneous LAAC, concentrating on current challenges and unmet needs.

Keywords: Left atrial appendage closure; Nonvalvular atrial fibrillation; Oral anticoagulation; Stroke; Transient ischemic attack.

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Conflict of interest statement

Declarations. Conflict of interest: All the authors have no conflicts of interest to declare.

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