{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:21:34Z","timestamp":1783779694399,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T00:00:00Z","timestamp":1694131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left atrial appendage occlusion (LAAO) has been considered an alternative treatment to prevent embolic stroke in patients with nonvalvular atrial fibrillation (NVAF). However, it carries a risk of general anesthesia or esophageal injury if guided by transesophageal echocardiography (TEE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to investigate the feasibility and safety of minimal LAAO (MLAAO) using Watchman under fluoroscopy guidance alone in patients with NVAF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 249 consecutive patients with NVAF who underwent LAAO using the WATCHMAN device were divided into two groups: the Standard LAAO (SLAAO) group and the MLAAO group. Procedural characteristics and follow\u2010up results were compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no statistically significant difference in the rate of successful device implantation (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Fluoroscopy time, radiation exposure dose, and contrast medium usage in the MLAAO group were higher than those in the SLAAO group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The procedure time and hospitalization duration were significantly lower in the MLAAO group than those in the SLAAO group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The occluder compression ratio, measured with fluoroscopy, was lower than that measured with TEE (17.63\u2009\u00b1\u20093.75% vs. 21.69\u2009\u00b1\u20094.26%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Significant differences were observed between the SLAAO group and the MLAAO group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) in terms of oropharyngeal\/esophageal injury, hypotension, and dysphagia. At 3 months after LAAO, the MLAAO group had a higher incidence of residual flow within 1\u22125\u2009mm compared to the SLAAO group, although the difference was not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MLAAO guided by fluoroscopy, instead of TEE, without general anesthesia simplifies the operational process and may be considered safe, effective, and feasible, especially for individuals who are unable to tolerate or unwilling to undergo TEE or general anesthesia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30838","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T13:00:18Z","timestamp":1694178018000},"page":"119-128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A preliminary study of minimal left atrial appendage occlusion using Watchman under the guidance of fluoroscopy"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-0010","authenticated-orcid":false,"given":"Zhong\u2010bao","family":"Ruan","sequence":"first","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2010wei","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge\u2010cai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010guo","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology The affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine Nanjing Medical University Taizhou P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.14797\/mdcj-11-2-100"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-020-02127-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.08.089"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.08.070"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14292"},{"key":"e_1_2_9_7_1","first-page":"1113","article-title":"Minimalistic approach to left atrial appendage occlusion using the LAmbre device","volume":"11","author":"So C","year":"2018","journal-title":"JACC"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12151"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2022.63.4.325"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10660"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24872"},{"key":"e_1_2_9_12_1","first-page":"5335","article-title":"The efficacy of trans\u2010esophageal echocardiography in treatment of nonvalvular atrial fibrillation with left atrial appendage occlusion","volume":"22","author":"Song Y","year":"2018","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00943"},{"key":"e_1_2_9_14_1","first-page":"297","article-title":"Feasibility of left atrial appendage occlusion without preprocedural transesophageal echocardiography or CT scanning","volume":"27","author":"Hammersley D","year":"2015","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13820"},{"key":"e_1_2_9_16_1","first-page":"643","article-title":"Intracardiac echocardiography to guide watchman FLX implantation","volume":"16","author":"Nielsen\u2010Kudsk JE","year":"2023","journal-title":"JACC"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.000153"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12909"},{"key":"e_1_2_9_19_1","article-title":"A comparison of cardiac computed tomography, transesophageal and intracardiac echocardiography, and fluoroscopy for planning left atrial appendage closure","volume":"13","author":"Osmancik P","year":"2021","journal-title":"J Atr Fibrillation"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2021.20349"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz258"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-01107"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.075"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30838","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T07:59:59Z","timestamp":1741766399000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.30838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,8]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/ccd.30838"],"URL":"https:\/\/doi.org\/10.1002\/ccd.30838","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,8]]},"assertion":[{"value":"2023-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}