Safety and feasibility of peri-device leakage closure after LAAO: an international, multicentre collaborative study.
EuroIntervention
; 17(12): e1033-e1040, 2021 Dec 17.
Article
en En
| MEDLINE
| ID: mdl-34219662
ABSTRACT
BACKGROUND:
Residual peri-device leakage (PDL) is frequent after left atrial appendage occlusion (LAAO). Little is known about management strategies, procedural aspects and outcomes of interventional PDL closure.AIMS:
The aim of this study was to assess the safety and feasibility of PDL closure after LAAO.METHODS:
Fifteen centres contributed data on baseline characteristics, in-hospital and follow-up outcomes of patients who underwent PDL closure after LAAO. Outcomes of interest included acute success and complication rates and long-term efficacy of the procedure.RESULTS:
A total of 95 patients were included and a cumulative number of 104 leaks were closed. The majority of PDLs were detected within 90 days (range 41-231). Detachable coils were the most frequent approach (42.3%), followed by the use of the AMPLATZER Vascular Plug II (29.8%) and the AMPLATZER Duct Occluder II (17.3%). Technical success was 100% with 94.2% of devices placed successfully within the first attempt. There were no major complications requiring surgical or transcatheter interventions. During follow-up (96 days [range 49-526]), persistent leaks were found in 18 patients (18.9%), yielding a functional success rate of 82.7%, although PDLs were significantly reduced in size (pre-leak sizemax 6.1±3.6 mm vs post-leak sizemax 2.5±1.3 mm, p<0.001). None of the patients had a leak >5 mm. Major adverse events during follow-up occurred in 5 patients (2 ischaemic strokes, 2 intracranial haemorrhages, and 1 major gastrointestinal bleeding).CONCLUSIONS:
Several interventional techniques have become available to achieve PDL closure. They are associated with high technical and functional success and low complication rates.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Dispositivo Oclusor Septal
Tipo de estudio:
Clinical_trials
Límite:
Humans
Idioma:
En
Revista:
EuroIntervention
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
TERAPEUTICA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Alemania