000			04644nam a22006737a 4500
008			190621s20192019 xxu||||| |||| 00| 0 eng d
022			_a1936-8798
040			_aOvid MEDLINE(R)
099			_a31103540
245			_aIncidence, Characterization, and Clinical Impact of Device-Related Thrombus Following Left Atrial Appendage Occlusion in the Prospective Global AMPLATZER Amulet Observational Study.
251			_aJacc: Cardiovascular Interventions. 12(11):1003-1014, 2019 06 10.
252			_aJACC Cardiovasc Interv. 12(11):1003-1014, 2019 06 10.
252			_zJACC Cardiovasc Interv. 12(11):1003-1014, 2019 Jun 10.
253			_aJACC. Cardiovascular interventions
260			_c2019
260			_fFY2020
265			_sppublish
266			_d2019-06-21
268			_aJacc: Cardiovascular Interventions. 12(11):1003-1014, 2019 Jun 10.
269			_fFY2019
520			_aBACKGROUND: DRT is a potential serious complication of LAAO, but the incidence and clinical impact of DRTs in a real-world setting are not well characterized.
520			_aCONCLUSIONS: Following LAAO with the AMPLATZER Amulet device, DRT was observed infrequently. Although the presence of DRT was associated with an increased rate of ischemic stroke or transient ischemic attack as compared with patients without DRT, the large majority of DRT patients (82%) did not experience any ischemic neurologic events.
520			_aCopyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
520			_aMETHODS: A total of 1,088 patients were enrolled in a multicenter prospective study and followed for 1 year. All events were adjudicated by an independent committee, including the presence of DRT. Patients with DRT were reviewed for suboptimal device implantation and characterization of DRT formation. Multiple Cox regression was performed to identify predictors of DRT formation.
520			_aOBJECTIVES: This study sought to report the incidence, characteristics, and clinical impact of device-related thrombus (DRT) following left atrial appendage occlusion (LAAO) with the AMPLATZER Amulet device (Abbott, Plymouth, Minnesota).
520			_aRESULTS: Device implantation was successful in 1,078 (99%) patients, with 1-year follow-up completed in 96.3% of patients. A total of 18 DRTs occurred in 17 patients (1.7%/year), as a second DRT developed following complete resolution of an initial DRT in 1 patient. The left upper pulmonary vein ridge was not covered by the Amulet disc in 82% of DRT patients, indicating suboptimal implantation, with most thrombus developing in the untrabeculated area of the LAA ostium between the pulmonary vein ridge and the upper edge of the disc. Three (18%) DRT patients had an ischemic stroke, all within 3 months of DRT diagnosis. Patients with a DRT were at a greater risk for ischemic stroke or transient ischemic attack compared with non-DRT patients (hazard ratio: 5.27; 95% confidence interval: 1.58 to 17.55; p = 0.007). Larger LAA orifice width was a predictor of DRT formation (hazard ratio: 1.09; 95% confidence interval: 1.00 to 1.19; p = 0.04).
546			_aEnglish
650			_a*Atrial Appendage/pp [Physiopathology]
650			_a*Atrial Fibrillation/th [Therapy]
650			_a*Cardiac Catheterization/ae [Adverse Effects]
650			_a*Cardiac Catheterization/is [Instrumentation]
650			_a*Thrombosis/ep [Epidemiology]
650			_aAged
650			_aAged, 80 and over
650			_aAtrial Appendage/dg [Diagnostic Imaging]
650			_aAtrial Fibrillation/dg [Diagnostic Imaging]
650			_aAtrial Fibrillation/ep [Epidemiology]
650			_aAtrial Fibrillation/pp [Physiopathology]
650			_aBrain Ischemia/ep [Epidemiology]
650			_aFemale
650			_aHumans
650			_aIncidence
650			_aIschemic Attack, Transient/ep [Epidemiology]
650			_aMale
650			_aProgression-Free Survival
650			_aProspective Studies
650			_aProsthesis Design
650			_aRisk Assessment
650			_aRisk Factors
650			_aStroke/ep [Epidemiology]
650			_aThrombosis/dg [Diagnostic Imaging]
650			_aTime Factors
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aAsch, Federico M
790			_aAminian A, Asch FM, Berti S, Cruz-Gonzalez I, Fischer S, Gage R, Lam SCC, Lund J, Mazzone P, Montorfano M, Nielsen-Kudsk JE, Omran H, Schmidt B, Tarantini G
856			_uhttps://dx.doi.org/10.1016/j.jcin.2019.02.003 _zhttps://dx.doi.org/10.1016/j.jcin.2019.02.003
942			_cART _dArticle
999			_c4348 _d4348