20.500.12556/DiRROS-24979 Multi-modality approach to detect device-related thrombus after left atrial appendage occlusion a case report Background: There has been a growing interest in using left atrial appendage occlusion (LAAO) for stroke prevention in patients with atrial fibrillation (AF) who are ineligible for oral anticoagulation. However, device-related thrombus (DRT) may occur after LAAO implantation and poses significant diagnostic and treatment challenges. Case summary: We describe a case of a patient who suffered an intracranial pontine haemorrhage while on anticoagulation with rivaroxaban for permanent atrial fibrillation and successfully underwent implantation of the LAAO device. Early follow-up transoesophageal echocardiography (TOE) with 3D multi-plane reconstruction revealed a large echo-dense mass on the left atrial aspect of the device. Cardiac computed tomography angiography confirmed a thrombus adherent to the LAAO device. After deciding on the treatment strategy, complete thrombus resolution was achieved at the 6 months follow-up and the patient was free of any thromboembolic and bleeding events. Discussion: Although DRT is a rare complication following LAAO procedure, an accurate diagnosis is crucial for the specific treatment. Multi-modality imaging approach with TOE and cardiac computed tomographic angiography as complementary methods is helpful to detect complications after LAAO procedure in challenging cases. atrial fibrillation cardiac computer tomography left atrial appendage occlusion transoesophageal echocardiography atrijska fibrilacija računalniška tomografija srca transezofagealni ultrazvok zapiralo avrikule levega preddvora true false true Angleški jezik Slovenski jezik Neznano 2026-01-07 07:50:53 2026-01-07 07:50:53 2026-01-08 03:47:20 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 7. 1. 2026; str. 1-5 issue 8 Vol. 9 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.1 2514-2119 10.1093/ehjcr/ytaf363 263660547 RAZ_Maiga_Hamady_Ibrahim_2025.pdf RAZ_Maiga_Hamady_Ibrahim_2025.pdf 1 41BB9675C6EE2E00303A5A2DF96B5503 a9fef050287fabe7ca50bf427e31ccb75992e7bca88acd07d8d1ef388de58939 90e3bc4a-eb95-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37435 https://academic.oup.com/ehjcr/article/9/8/ytaf363/8222143 0 a2c9fc61-eb95-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37436 Univerzitetni klinični center Ljubljana 0 0 0