{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:48:37Z","timestamp":1784184517954,"version":"3.55.0"},"reference-count":38,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Background: Left atrial appendage closure (LAAC) is a safe and effective method for preventing embolic events in patients with non-valvular atrial fibrillation. However, peri-device leaks (PDLs) are sometimes unavoidable. Controversy exists regarding whether PDLs lead to embolic events. Objectives: This study aimed to explore the association between PDLs and embolic events, including ischaemic stroke, transient ischaemic attacks (TIAs), and systemic embolism (SE). Methods: We conducted a systematic search of the PubMed, Web of Science, MEDLINE, and Cochrane Library databases for studies published up to September 25, 2022, to compare the rate of ischaemic stroke\/TIA\/SE between the PDL group and the non-PDL group after LAAC. Results: Thirteen studies comprising 54,405 patients were included in the meta-analysis. The PDL group detected by transoesophageal echocardiography (TEE) had a significantly higher rate of ischaemic stroke\/TIA\/SE than the non-PDL group (OR: 1.20, 95% CI: 1.08\u20131.33, p = 0.0009). However, no difference in ischaemic stroke\/TIA\/SE was found between the PDL and non-PDL subgroups of the cardiac computed tomography angiography (CCTA) group (OR: 1.12, 95% CI: 0.51\u20132.50, p = 0.77). CCTA and TEE showed different rates of PDL detection, with the CCTA group having a higher rate of PDL detection (p &amp;lt; 0.0001), especially for trivial leaks. Conclusions: PDL detected by TEE increases the risk of embolic events after LAAC. However, no association was found between PDL and ischaemic stroke\/TIA\/SE in the CCTA group, which showed a higher rate of PDL detection than TEE, particularly for trivial leaks. In the future, CCTA may be used to explore the relationship between PDL size and ischaemic stroke\/TIA\/SE. <\/jats:p>","DOI":"10.1159\/000532019","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T06:58:00Z","timestamp":1691477880000},"page":"581-592","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of Peri-Device Leaks on Ischaemic Stroke\/Transient Ischaemic Attack\/Systemic Embolism after Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis"],"prefix":"10.1159","volume":"148","author":[{"given":"Yin-Ge","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Hua","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Tan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan-Pan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Jie","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.10.017"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.021"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29856"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14824"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29856"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29318"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05535-y"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys041"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-011-9613-x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.020"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2015.08.005"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-018-1288-1"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.12.022"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.12.004"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-00320"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2021.06.018"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.111989"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.06.009"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2021.04.019"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309782"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.07.052"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.11.018"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.08.075"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29495"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.10.031"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.089"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25667"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-01107"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25667"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-021-02192-5"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000566"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-01107"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2020.12.003"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006841"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.11.001"}],"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/crd\/article-pdf\/148\/6\/581\/4062300\/000532019.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/crd\/article-pdf\/148\/6\/581\/4062300\/000532019.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:31:50Z","timestamp":1745422310000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000532019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,12,18]]},"published-print":{"date-parts":[[2023,12,19]]}},"URL":"https:\/\/doi.org\/10.1159\/000532019","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"value":"0008-6312","type":"print"},{"value":"1421-9751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]}}}