Key result
LAmbre occluder linked to ~425% higher device-related thrombus risk vs other LAAC devices.
Why the study?
Although the LAmbre occluder adapts well to left atrial appendage anatomy, some studies reported a higher incidence of device-related thrombus, prompting a comparison of its safety and efficacy with other LAAC devices.
Does the LAmbre occluder increase the risk of device-related thrombus compared to other LAAC devices in patients with atrial fibrillation?
Meta-Analysis (n=607)
Does the LAmbre occluder increase the risk of device-related thrombus compared to other LAAC devices in patients with atrial fibrillation?
The LAmbre LAAC device is associated with a higher risk of device-related thrombus compared to other LAAC devices, though rates of stroke and mortality are similar.
Answers are grounded in this paper and cite their sources.
LAmbre may suit complex LAA anatomies; meta-analysis extends device comparisons but leaves practice implications open pending RCTs.
The LAmbre occluder is more convenient to operate than other left atrial appendage closures(LAAC), and it can adapt to different anatomy of left atrial appendage. However, some studies showed that Lambre occluder had a higher incidence of device-related thrombus(DRT). This meta-analysis aims to compare the safety and efficacy of the LAmbre occluder with other LAAC devices. Eligible studies were retrieved from PubMed, Embase and the Cochrane Library up to 1 July 2022 and reported the results. Five studies of a total of 607 patients were included in the meta-analysis. The LAmbre occluder was associated with higher rate of DRT(OR [95% CI] = 5.25 [1.21, 22.86], P =0.03; I2=0%). No significant differences were observed in the incidence of procedure-related death, pericardial effusion, chest pain, bleeding and vessel complication, contrast medium, fluoroscopy time ,death, stroke, bleeding events, systemic embolism and peri-device leakage. In conclusion, the LAmbre occluder had higher incidence of DRT than other LAAC devices, and there were no significant differences in stroke, bleeding events, and mortality.
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Pan et al. (2022) conducted a meta-analysis in atrial fibrillation (n=607). LAmbre occluder vs. other LAAC devices was evaluated on device-related thrombus (DRT) (OR 5.25, 95% CI 1.21-22.86, p=0.03). The LAmbre occluder was associated with a higher rate of device-related thrombus compared to other LAAC devices.
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