Intracardiac or transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis.
Details
Serval ID
serval:BIB_8EB478C08BE2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intracardiac or transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis.
Journal
The international journal of cardiovascular imaging
ISSN
1875-8312 (Electronic)
ISSN-L
1569-5794
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Abstract
Intracardiac echocardiography (ICE) appears to be a potential alternative for percutaneous left atrial appendage occlusion (LAAO) to transesophageal echocardiography (TEE). Thus, a meta-analysis was performed comparing ICE vs. TEE for LAAO guidance.
A comprehensive literature search was performed using MEDLINE, Scopus and Web of Science electronic databases from their inception to November 2023.
18 studies (124,230 patients) were included. Technical success was higher in ICE- compared to TEE-guidance (OR: 1.36, 95% CI 1.14 to 1.63, p = 0.006) and fewer devices employed (SMD: -0.22, 95% CI -0.43 to -0.01, p = 0.04, I2 = 62%). ICE guidance related with more pericardial effusion/tamponade and iatrogenic residual shunts (logRR: 0.62, 95% CI 0.36 to 0.89, p < 0.001 and RR: 1.53, 95% CI 1.12 to 2.09, p = 0.02, I2 = 1%, respectively). More vascular complications were noted in ICE group (logRR: 0.45, 95% CI 0.11 to 0.78, p = 0.009).
ICE-guided imaging is an effective alternative to TEE in LAAO, as it shows better efficacy than TEE, considering technical success. However, the higher rates of adverse events should be carefully considered.
A comprehensive literature search was performed using MEDLINE, Scopus and Web of Science electronic databases from their inception to November 2023.
18 studies (124,230 patients) were included. Technical success was higher in ICE- compared to TEE-guidance (OR: 1.36, 95% CI 1.14 to 1.63, p = 0.006) and fewer devices employed (SMD: -0.22, 95% CI -0.43 to -0.01, p = 0.04, I2 = 62%). ICE guidance related with more pericardial effusion/tamponade and iatrogenic residual shunts (logRR: 0.62, 95% CI 0.36 to 0.89, p < 0.001 and RR: 1.53, 95% CI 1.12 to 2.09, p = 0.02, I2 = 1%, respectively). More vascular complications were noted in ICE group (logRR: 0.45, 95% CI 0.11 to 0.78, p = 0.009).
ICE-guided imaging is an effective alternative to TEE in LAAO, as it shows better efficacy than TEE, considering technical success. However, the higher rates of adverse events should be carefully considered.
Keywords
Echocardiography, Intracardiac, Left atrial appendage, Occlusion, Transesophageal
Pubmed
Open Access
Yes
Create date
24/01/2025 15:24
Last modification date
25/01/2025 7:04