title: Rationale of cerebral protection devices in left atrial appendage occlusion.
abstract: OBJECTIVE
  Aims of this case-series were to assess the feasibility of cerebral protection devices in interventional left atrial appendage occlusion (iLAAO) procedures and to yield insight into the pathomorphological correlate of early, procedural cerebral embolization during iLAAO.
  
  
  RESULTS
  Five consecutive patients underwent iLLO flanked by the Sentinel CPS® (Claret Medical, Inc., Santa Rosa, CA) cerebral protection system. Placement and recapture of the Sentinel®device as well as the iLAAO were successful and safe in all cases. Histomorphometric analysis of the collected filters showed embolized debris in all patients. Acute thrombus was found in three patients, organizing thrombus in four. Interestingly, two patients had endocardial or myocardial tissue in their filters.
  
  
  CONCLUSIONS
  Cerebral protection during iLAAO with the Sentinel CPS®device is feasible. Furthermore, this dataset identifies the formation and embolization of thrombus and cardiac tissue as emboligeneic sources and potential future targets to reduce procedural complications. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Meincke
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Spangenberg
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Kreidel
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Frerker
authors.affiliation: CV Path Institute, Inc, Gaithersburg, MD.
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
authors.affiliation: CV Path Institute, Inc, Gaithersburg, MD.
authors.forename: Elena
authors.initials: E
authors.lastname: Ladich
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: Department for Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.|Medizinische Klinik II, Universitaetsklinikum Bonn, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ghanem
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001706:Biopsy; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D057505:Embolic Protection Devices; D005240:Feasibility Studies; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010865:Pilot Projects; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: TIA; amulet; atrial fibrillation; cerebral protection device; left atrial appendage occlusion; stroke; watchman