Comparison of intracardiac and transoesophageal echocardiography for guidance of percutaneous left atrial appendage occlusion: A meta-analysis
Comparison of intracardiac and transoesophageal echocardiography for guidance of percutaneous left atrial appendage occlusion: A meta-analysis
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DOI：
10.1111/echo.14415
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发表时间：
2019-07-01
影响因子：
1.5
通讯作者：
Goncalves, Lino
中科院分区：
文献类型：
--
作者：
Ribeiro, Joana Maria;Teixeira, Rogerio;Goncalves, Lino
目的比较心内超声心动图(ICE)和经食道超声心动图(TOE)在经皮左心耳闭塞(LAAO)治疗中的安全性和有效性。方法与结果利用MEDLINE、Cochrane图书馆和Google Scholar电子数据库对文献进行全面检索，检索时间从最初到2018年12月。将ICE和TOE用于经皮LAAO指导的文献纳入分析范围。共同的主要终点是手术成功和与手术相关的并发症。次要终点包括程序和透视时间以及使用的造影剂的体积。分析中包括五项研究，总共提供了1122名患者。两种术式的手术成功率相似(合并奇比[OR]1.46，95%可信区间[CI]0.77~2.75，P=0.24，I-2=0%)，但ICE组手术相关并发症较少(合并OR为0.57，95%CI为0.31~1.05，P=0.07，I-2=0%)。两组间操作时间(平均差异-1.64分钟，95%CI-16.42~13.14，P=0.83，I-2=96%)和透视时间(平均差异+1.29分钟，95%CI-1.38~3.97，P=0.34，I-2=76%)均无显著差异。ICE组造影剂用量减少(平均差值-9.71毫升，95%可信区间-14.61至-4.81，P>；0.01，I-2=0)。结论心内超声心动图是一种安全、有效的替代TOE的经皮LAAO引导方法。
Aims We performed a meta-analysis to compare the safety and efficacy of intracardiac echocardiography (ICE) vs transoesophageal echocardiography (TOE) for the guidance of percutaneous left atrial appendage occlusion (LAAO). Methods and Results A comprehensive search of the literature was performed, from inception to December 2018 using MEDLINE, Cochrane Library, and Google Scholar electronic databases, and references from articles. Publications comparing ICE and TOE for the guidance of percutaneous LAAO were included in the analysis. The co-primary endpoints were procedural success and procedure-related complications. Secondary endpoints included procedural and fluoroscopy times and the volume of contrast media used. Five studies were included in the analysis, providing a total of 1122 patients. Procedural success was similar with both techniques (pooled odd ratio [OR] 1.46, 95% confidence interval [CI] 0.77-2.75, P = 0.24, I-2 = 0%), with a trend for less procedure-related complications in the ICE group (pooled OR 0.57, 95% CI 0.31-1.05, P = 0.07, I-2 = 0%). Neither procedural (mean difference -1.64 minutes, 95% CI -16.42 to 13.14, P = 0.83, I-2 = 96%) nor fluoroscopy times (mean difference + 1.29 minutes, 95% CI -1.38 to 3.97, P = 0.34, I-2 = 76%) varied significantly between groups. There was a reduction in the volume of contrast media used in the ICE group (mean difference -9.71 mL, 95% CI -14.61 to -4.81, P > 0.01, I-2 = 0%). Conclusion Intracardiac echocardiography is a safe and effective alternative to TOE for guidance of percutaneous LAAO.