JACC. Case reports · 2026
Direction-Controlled Retrieval of an Embolized Left Atrial Appendage Closure Device.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Ueshima Daisuke, Shinozaki Tomoya, Sumiyoshi Hironobu, Kono Toshikazu, Ono Maki, Mizukami Akira, Sasano Tetsuo
Аннотация
BACKGROUND: Embolization of left atrial appendage (LAA) closure devices is an uncommon but potentially serious complication. Conventional snaring techniques may not provide adequate control of device orientation, increasing the risk of anchor entrapment and vascular injury.
CASE PRESENTATION: A 67-year-old man with persistent atrial fibrillation and recurrent colonic diverticular bleeding underwent LAA closure using a 31-mm WATCHMAN FLX Pro device. Despite satisfactory positioning based on the PASS (Position, Anchor, Size, Seal) criteria, device embolization to the aortic arch occurred shortly after deployment. Percutaneous retrieval was performed using a direction-controlled wire loop snaring technique. A guidewire was advanced through a fabric-free strut of the device and captured with a snare, enabling controlled traction and alignment during extraction. The device was successfully withdrawn into a large-bore sheath and removed without complications. A second device was subsequently implanted successfully.
DISCUSSION: This technique enables active control of device orientation during retrieval and may reduce the risk of anchor-related injury and improve procedural reproducibility.
TAKE-HOME MESSAGES: Precise control of device orientation is critical during retrieval of embolized LAA closure devices to avoid anchor-related injury. A direction-controlled wire loop snaring technique may improve the safety and reproducibility of percutaneous retrieval.
CASE PRESENTATION: A 67-year-old man with persistent atrial fibrillation and recurrent colonic diverticular bleeding underwent LAA closure using a 31-mm WATCHMAN FLX Pro device. Despite satisfactory positioning based on the PASS (Position, Anchor, Size, Seal) criteria, device embolization to the aortic arch occurred shortly after deployment. Percutaneous retrieval was performed using a direction-controlled wire loop snaring technique. A guidewire was advanced through a fabric-free strut of the device and captured with a snare, enabling controlled traction and alignment during extraction. The device was successfully withdrawn into a large-bore sheath and removed without complications. A second device was subsequently implanted successfully.
DISCUSSION: This technique enables active control of device orientation during retrieval and may reduce the risk of anchor-related injury and improve procedural reproducibility.
TAKE-HOME MESSAGES: Precise control of device orientation is critical during retrieval of embolized LAA closure devices to avoid anchor-related injury. A direction-controlled wire loop snaring technique may improve the safety and reproducibility of percutaneous retrieval.