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Introduction: Indications for left atrial appendage occlusion (LAAO) are varied and patients require individual management strategies. However, currently no guidelines exist for postprocedure oral anticoagulation (OAC) after an LAAO procedure. Aim: To evaluate the effect of OAC on thromboembolism, bleeding and mortality following the LAAO procedure for patients with AF. Material and methods: One hundred and thirty-nine consecutive patients with nonvalvular atrial fibrillation (NVAF) who underwent LAAO with the LARIAT device were followed for at least 40 months. Decisions about OAC and its modifications were individualized based on clinical presentation, patient and physician preferences. Results: Following LAAO, 52 (41%) patients did not receive OAC (No-OAC group) and 75 (59%) patients received OAC (OAC group), without any intergroup differences in CHADS2, CHA2DS2-VASc score or other thromboembolic risk factors. The median HAS-BLED score was higher in the OAC-group (median 3 (3-4) vs. 3 (2-4), p = 0.014). During a median follow-up time of 51 (43-57) vs. 55 (48-59) months in the No-OAC group and in the OAC group (p = 0.19) there were no significant differences between groups in ischemic stroke/TIA, 0 (0%) vs. 2 (2.7%), other thromboembolic events, 0 (0%) vs. 1 (1.3%), life-threatening, disabling or major events, 2 (3.7%) vs. 2 (2.7%), or annual mortality rate, 1.9% vs. 0.9%, respectively. Conclusions: There is no need for OAC after the LAAO procedure. Omitting OAC after an LAAO procedure in AF patients: (1) has similar stroke prevention rates as patients on OAC, (2) has similar bleeding prevention rates as patients on OAC, (3) has similar safety endpoints and long-term efficacy as patients on OAC. [ABSTRACT FROM AUTHOR]

Cerebral venous thrombosis (CVT), also known as a venous stroke, is relatively rare, more common in young people, and about 3/4 of patients are women. This disease may contribute to focal brain damage. The paper presents a case of a young man after a fall from a height with associated polytrauma (including basilar skull fracture), in which on the basis of magnetic resonance imaging transverse and sigmoid sinus thrombosis of the right side was diagnosed. Despite long-term anticoagulation, complete regression of thrombotic lesions has not been achieved. The clinical course of the described case raises a number of doubts about how to proceed in this group of patients, especially in the case of possible complications. Because so far clear standards of behavior therapy in venous thrombosis and cerebral sinus have not been established, it is still an important diagnostic and therapeutic problem. [ABSTRACT FROM AUTHOR]