ISC 2026 | Stroke mechanism and severity after left atrial appendage occlusion: LAAOS III
Aristeidis Katsanos, MD, PhD, McMaster University, Hamilton, Canada, shares insights from the LAAOS III trial (NCT01561651) on stroke mechanism and severity after left atrial appendage occlusion. The study found that the strokes prevented by surgical appendage occlusion were primarily cardioembolic strokes, and that the strokes that did occur in the treatment group were less severe and had lower stroke-related mortality compared with the control group. This interview took place at the 2026 International Stroke Congress (ISC), held in New Orleans, LA.
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Transcript
Yeah, so LAAOS III is a trial that evaluated a closure of the appendix in that surgical closure in people with AFib that they were undergoing cardiac surgery. So people that got into the trial, if they had AFib, they had an indication to undergo cardiac surgery and they had a history of atrial fibrillation. So they were randomized either to have their left atrial appendage closed through a surgical procedure versus not...
Yeah, so LAAOS III is a trial that evaluated a closure of the appendix in that surgical closure in people with AFib that they were undergoing cardiac surgery. So people that got into the trial, if they had AFib, they had an indication to undergo cardiac surgery and they had a history of atrial fibrillation. So they were randomized either to have their left atrial appendage closed through a surgical procedure versus not. So the primary publication did show that there was a significant risk reduction for stroke in people that had the left atrial appendage amputated. So what we did, we did take a closer look and phenotype the strokes that happened in the trial. So we came up with some very interesting findings. So first of all, we did find out that most of the strokes that were prevented from the surgical appendage occlusion was in fact cardioembolic stroke. So there was a reduction in cardioembolic strokes. And we also found out that the strokes that happened in the group that were randomized to receive the surgical occlusion, they were of less severity compared to the individuals that had their left atrial appendage opened or not treated surgically. We also found out that the stroke-related mortality in the individuals that the left atrial appendage was surgically occluded had less deadly strokes, less stroke-related mortality.
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