From the Research
Treatment for Lambl's excrescences associated with stroke should prioritize anticoagulation therapy, as it has been shown to be effective in preventing recurrent strokes in patients with these valve projections. According to the most recent study 1, anticoagulation therapy is recommended for patients who have experienced a stroke attributed to Lambl's excrescences. The study highlights the importance of transesophageal echocardiography in diagnosing Lambl's excrescences and emphasizes the need for anticoagulation therapy to prevent recurrent strokes.
Some key points to consider in the treatment of Lambl's excrescences associated with stroke include:
- Anticoagulation therapy with warfarin (target INR 2-3) or direct oral anticoagulants like apixaban (5 mg twice daily) or rivaroxaban (20 mg daily) may be recommended for higher-risk patients or those with recurrent events despite antiplatelet therapy 1
- Antiplatelet therapy with aspirin (81-325 mg daily) may be considered as first-line treatment for patients who have experienced a stroke attributed to Lambl's excrescences 2
- Surgical intervention to remove the excrescences is rarely necessary but may be considered in cases of recurrent strokes despite optimal medical therapy 2
- Lifestyle modifications to reduce overall cardiovascular risk, including blood pressure control, smoking cessation, and cholesterol management, are also important components of comprehensive management 3
It is essential to note that the treatment approach aims to prevent thrombus formation on these valve projections, which can embolize and cause strokes. Regular follow-up with both neurology and cardiology is essential to monitor treatment efficacy and adjust therapy as needed. As stated in the study 4, anticoagulation therapy has been shown to be effective in preventing recurrent strokes in patients with Lambl's excrescences. Therefore, anticoagulation therapy should be prioritized in the treatment of Lambl's excrescences associated with stroke.