{"title":"[Percutaneous left atrial appendage closure for atrial fibrillation-related ischemic stroke despite direct oral anticoagulation: a case report].","authors":"Kenshin Kawabata, Shuhei Egashira, Kyosuke Muramatsu, Fumiaki Henmi, Megumi Ubano, Akinori Konishi, Nami Omori, Tetsuo Yamaguchi, Takahide Kodama, Yoshikazu Uesaka","doi":"10.5692/clinicalneurol.cn-002206","DOIUrl":null,"url":null,"abstract":"<p><p>A 79-year-old woman developed weakness in her right upper and lower limbs despite appropriate therapy with edoxaban 30 mg once daily for non-valvular atrial fibrillation (CHA2DS2-VASc score of 7, HAS-BLED score of 3). Brain MRI revealed an acute infarct in the territory of the left long insular artery or white-matter medullary artery. Transesophageal echocardiogram showed spontaneous echo contrast and reduced flow velocities in the left atrial appendage (LAA), leading to a diagnosis of cardioembolic stroke. Edoxaban was continued, and the patient underwent percutaneous left atrial appendage occlusion (LAAO). Her clinical course was uncomplicated by recurrent ischemic stroke or device-related thrombosis. For patients with atrial fibrillation-related ischemic stroke despite anticoagulation, adding LAAO to ongoing anticoagulation may be an effective option for secondary prevention.</p>","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"171-176"},"PeriodicalIF":0.0000,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5692/clinicalneurol.cn-002206","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/13 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
A 79-year-old woman developed weakness in her right upper and lower limbs despite appropriate therapy with edoxaban 30 mg once daily for non-valvular atrial fibrillation (CHA2DS2-VASc score of 7, HAS-BLED score of 3). Brain MRI revealed an acute infarct in the territory of the left long insular artery or white-matter medullary artery. Transesophageal echocardiogram showed spontaneous echo contrast and reduced flow velocities in the left atrial appendage (LAA), leading to a diagnosis of cardioembolic stroke. Edoxaban was continued, and the patient underwent percutaneous left atrial appendage occlusion (LAAO). Her clinical course was uncomplicated by recurrent ischemic stroke or device-related thrombosis. For patients with atrial fibrillation-related ischemic stroke despite anticoagulation, adding LAAO to ongoing anticoagulation may be an effective option for secondary prevention.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
