Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives

Stroke accounts for significant morbidity and mortality worldwide. Accordingly, appropriate prevention is crucial to reduce the global burden of stroke. Percutaneous left atrial appendage closure (LAAC) is a viable approach for preventing cardioembolic stroke in patients with non-valvular atrial fibrillation who have a contraindication to long-term oral anticoagulation due to a non-reversible cause. In the last 2 decades, percutaneous LAAC has become a rapidly evolving field, with multiple devices approved or under clinical development. However, several issues remain, including limited high-quality evidence, late adverse events, and unclear post-procedural antithrombotic therapy. This review offers an up-to-date perspective on percutaneous LAAC, concentrating on current challenges and unmet needs.