Abstract: Thromboembolism is a serious complication of atrial fibrillation, and about 90% nonvalvular atrial fibrillation associated thrombus come from the left atrial appendage. Instead of long-term oral anticoagulation, percutaneous left atrial appendage closure (PLAAC) could be used to prevent thromboembolism, and many clinical studies have preliminarily proven the safety and efficiency of PLAAC. Meanwhile, the device-related thrombus (DRT) and embolization have aroused more and more attention. The early stage anti-thrombotic therapy is critical to prevent the development of DRT and embolization, however, the optimal strategy has not been confirmed. This is a comment on different early stage anti-thrombotic therapies and their DRT and embolization.