{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:25:03Z","timestamp":1788387903556,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The Watchman\u2010FLX left atrial appendage closure (LAAC) device presents innovative features: higher conformability, reduced length, closed distal \"flex\u2010ball\" during deployment, and flattened surface. We report our real\u2010world experience with the Watchman\u2010FLX device in two centers with consolidated LAAC expertise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 200 consecutive Watchman\u2010FLX patients (2019\u20132021) in a nonrandomized double\u2010center registry; procedural data and follow\u2010up for midterm clinical outcomes were collected. A control group of 100 patients treated with first\u2010generation Watchman (2.5) was included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to mean CHAD<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc (5\u2009\u00b1\u20091.40) and HAS\u2010BLED (3.8\u2009\u00b1\u20091.01) scores, the population included in this study was at high risk: 29% had a previous stroke and 56.5% a bleeding event. Main LAAC indications were symptomatic hemorrhage (39.5%), need for triple antithrombotic therapy (39%), gastrointestinal bleeding (32%), and oral anticoagulation intolerance (18%). Transesophageal echocardiography guidance was followed in 93% of cases (48% in general anesthesia and 45% under conscious sedation). Repositioning an FLX device was required in 20% of cases and no complication occurred. In 96% of patients, the first selected device was delivered, while in 4% a device size change was required after the first choice (7% with Watchman 2.5). Peridevice leaks (&lt;5\u2009mm) were found postimplant in two cases (1%). Overall, the procedural success rate was 99.5%. One patient's procedure was unsuccessful (0.5%), due to left atrial appendage\u00a0(LAA) anatomy; differently, the mean failure rate with Watchman 2.5 was 2%. No device embolization was reported. Complications (8.5%) were mainly related to the access site (3%); major bleedings (1%), and in\u2010hospital death (0.5%) rarely occurred. After a follow\u2010up of 272\u2009\u00b1\u2009173 days, 2.3% of cases experienced a non\u2010device\u2010related\u00a0stroke and 0.6% fatal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our registry showed a high procedural success rate of the Watchman\u2010FLX in a high\u2010risk population. According to our experience, the main advantages include easy implanting and repositioning, absence of embolization, good LAA sealing, and low rate of complications in the follow\u2010up period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30237","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T07:14:05Z","timestamp":1653030845000},"page":"154-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Real\u2010world experience with the new Watchman FLX device: Data from two high\u2010volume Sicilian centers. The FLX\u2010iEST registry"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7672-2291","authenticated-orcid":false,"given":"Giampiero","family":"Vizzari","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, A.O.U. Policlinic \u201cG. Martino\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Grasso","sequence":"additional","affiliation":[{"name":"Division of Cardiology CAST \u201cG. Rodolico\u201d, A.O.U. Policlinic \u201cVittorio Emanuele\u2010San Marco\u201d Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sardone","sequence":"additional","affiliation":[{"name":"Division of Cardiology CAST \u201cG. Rodolico\u201d, A.O.U. Policlinic \u201cVittorio Emanuele\u2010San Marco\u201d Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Mazzone","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, A.O.U. Policlinic \u201cG. Martino\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Laterra","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, A.O.U. Policlinic \u201cG. Martino\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Frazzetto","sequence":"additional","affiliation":[{"name":"Division of Cardiology CAST \u201cG. Rodolico\u201d, A.O.U. Policlinic \u201cVittorio Emanuele\u2010San Marco\u201d Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Sacchetta","sequence":"additional","affiliation":[{"name":"Cardiology Unit \u201cUmberto I\u201d Hospital, ASP Siracusa Siracusa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Micari","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, A.O.U. Policlinic \u201cG. Martino\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4940-9742","authenticated-orcid":false,"given":"Corrado","family":"Tamburino","sequence":"additional","affiliation":[{"name":"Division of Cardiology CAST \u201cG. Rodolico\u201d, A.O.U. Policlinic \u201cVittorio Emanuele\u2010San Marco\u201d Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Contarini","sequence":"additional","affiliation":[{"name":"Cardiology Unit \u201cUmberto I\u201d Hospital, ASP Siracusa Siracusa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJY19M08_01"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.040"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-018-0351-1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv730"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006841"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.021"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.076"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2018.09.007"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV12I1A18"},{"key":"e_1_2_10_13_1","first-page":"4","article-title":"Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies","volume":"19","author":"Tzikas A","year":"2017","journal-title":"Europace"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2022.01.022"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.33963\/KP.15172"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.06.056"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.06.028"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","unstructured":"GaleaR MahmoudiK GraniC et al.Watchman FLX vs. Watchman 2.5 in a dual\u2010center left atrial appendage closure cohort: the WATCH\u2010DUAL study.Europace. 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