Stroke risk - what else can be done (excluding blood thinners)

There are some people who are deemed high enough risk of stroke and require blood thinners, but for various reasons cannot take them. These reasons may include previous significant bleeding such as in the brain or in the gut. In these situations careful consideration is given to which blood thinners can be used. Now there may be situations where blood thinners cannot be used for these patients and so therefore we now have people at higher risk of stroke than the general public and a decision needs to be made if a blood thinner cannot be used is there something else that can be effective in reducing the stroke risk. Now in atrial fibrillation the atria, which are the collecting chamber at the top of the heart, is quivering instead of beating regularly and because of that blood can pool. If it pools it can clot, if it clots it can fire off to the brain causing the stroke and this is often pooling in a small area in this atria what we call the left atrial appendage or a little outpouching where blood can pool in that area. So we know if that's the main area where blood can pool and clot and those without blood thinners there is a procedure where that appendage in that atrium can be occluded so any blood clots in there cannot escape out of there and fire off into the brain and these are left atrial appendage occlusion devices. Procedure done through a similar route in the vessel in the leg up to the heart to the atrium and a device deployed to block the area where blood can pool to significantly reduce the risk of stroke from blood clotting in that area. It means therefore although blood thinners are first-line there are situations where blood thinners cannot be taken by some patients and in these situations a decision and an assessment is made whether other left atrial appendage occlusion device procedures are appropriate.