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<p>Transcatheter left atrial appendage closure (LAAC) serves as a mechanical stroke prevention strategy for patients with non-valvular atrial fibrillation (NVAF) who are unsuitable for long-term oral anticoagulation. Although device dislodgement following LAAC is rare, it carries potentially life-threatening risks. This case report describes a 65-year-old male with permanent atrial fibrillation (CHA2DS2-VASc = 4, HAS-BLED = 3) who underwent LAAC with an 18&#xa0;mm LAmbre occluder. Despite confirmed proper positioning at 1-month follow-up, device migration to the iliac bifurcation was detected at 105 days post-procedure, potentially associated with interim chest trauma. Percutaneous retrieval was performed via a novel approach: catheter-based endothelial detachment followed by bidirectional traction, avoiding large-bore sheaths. A Watchman FLX device was subsequently implanted successfully.</p>

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Late migration of a left atrial appendage closure device to the bifurcation of common iliac arteries: a case report and novel percutaneous retrieval technique

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月6日

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  • Ruchao Ma,
  • Pengyang Lin,
  • Gang Chen,
  • Guiqing Ma,
  • Shu Liu,
  • Ruixia Song,
  • Xin Lin

摘要

Transcatheter left atrial appendage closure (LAAC) serves as a mechanical stroke prevention strategy for patients with non-valvular atrial fibrillation (NVAF) who are unsuitable for long-term oral anticoagulation. Although device dislodgement following LAAC is rare, it carries potentially life-threatening risks. This case report describes a 65-year-old male with permanent atrial fibrillation (CHA2DS2-VASc = 4, HAS-BLED = 3) who underwent LAAC with an 18 mm LAmbre occluder. Despite confirmed proper positioning at 1-month follow-up, device migration to the iliac bifurcation was detected at 105 days post-procedure, potentially associated with interim chest trauma. Percutaneous retrieval was performed via a novel approach: catheter-based endothelial detachment followed by bidirectional traction, avoiding large-bore sheaths. A Watchman FLX device was subsequently implanted successfully.