浅谈经皮左心耳封堵术器械相关血栓栓塞及术后早期抗栓

A comment on device-related thrombus and early stage anti-thrombotic therapy after percutaneous left atrial appendage closure

血栓栓塞是心房颤动的严重并发症,90%的非瓣膜性心房颤动相关血栓来源于左心耳。经皮左心耳封堵术(percutaneous left atrial appendage closure, PLAAC)通过对左心耳进行介入封堵,以替代长期口服抗凝药物预防血栓栓塞。该技术的安全性和有效性已得到众多临床研究证实。同时,术后封堵器相关血栓形成及栓塞事件也引起学术界越来越多的关注,术后早期抗栓对防治术后器械相关血栓(device-related thrombus, DRT)的形成极其重要,但最优抗栓方案尚无定论。本文就目前临床使用的不同抗栓方案及术后器械相关血栓形成栓塞事件作一回顾及评述。

Thromboembolism is a serious complication of atrial fibrillation, and about 90% nonvalvular atrial fibrillation associated thrombus come from the left atrial appendage. Instead of long-term oral anticoagulation, percutaneous left atrial appendage closure (PLAAC) could be used to prevent thromboembolism, and many clinical studies have preliminarily proven the safety and efficiency of PLAAC. Meanwhile, the device-related thrombus (DRT) and embolization have aroused more and more attention. The early stage anti-thrombotic therapy is critical to prevent the development of DRT and embolization, however, the optimal strategy has not been confirmed. This is a comment on different early stage anti-thrombotic therapies and their DRT and embolization.