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Perioperative major acute cardiovascular events after 180-W GreenLight laser photoselective vaporization of the prostate

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Abstract

Background

Major acute cardiovascular events (MACE) prevalence after 180-W GreenLight (180-W GL) laser photoselective vaporization (PVP) have never been explored. Aim of our study is to evaluate perioperative MACE that occurred concomitantly with 180-W GL PVP.

Materials and methods

We relied on a multi-institutional database that included 14 centers. Data from 923 patients who underwent 180-W GL PVP were reviewed. We abstracted pre- and perioperative data of patients who experienced perioperative MACE, such as angina pectoris, acute myocardial infarction, other chronic ischemic heart disease, transient ischemic attack, or cerebrovascular accident as well as deep venous thrombosis with or without pulmonary embolism. We relied on a case-series format to report the main findings of our analyses.

Results

18 (1.9%) patients reported MACE in 7 centers. Median age was 69.5 (IQR 66.0–79.2) years. Of all, 7 patients underwent standard PVP and 11 anatomical PVP. Eleven patients (61.1%) were not under anticoagulant/antiplatelet treatment, 6 (33.3%) were under low dose aspirin, and 1 (5.6%) was under clopidogrel. Four patients (22.2%) had an instrumental and laboratory diagnosis of myocardial infarction, 7 (38.9%) had an episode of angina pectoris with or without rhythm alteration, 3 (16.7%) reported symptomatic deep venous thrombosis, and 4 (22.2%) had other MACE-like events.

Conclusions

Physician should take in consideration the possibility of MACE or MACE-like events. The real MACE rate may be different as only half of included centers reported MACE. Since the main target of laser surgery are high-risk bleeding patients, prospective observational trials focused on detection of these possible complications are warranted.

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Author information

MM, LC, FG: Project development, Data analysis, Manuscript writing. All the authors: Data collection. LS, LC, GF: Supervision. All the authors: Project development, Manuscript editing.

Correspondence to Luca Cindolo.

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Conflict of interest

LC, LR, PD, GF do surgical tutorship for AMS and received honoraria for their tutorship.

Ethical approval

For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study. This study and all the related procedures have been performed in accordance with the Declaration of Helsinki.

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Marchioni, M., Schips, L., Greco, F. et al. Perioperative major acute cardiovascular events after 180-W GreenLight laser photoselective vaporization of the prostate. Int Urol Nephrol 50, 1955–1962 (2018). https://doi.org/10.1007/s11255-018-1968-9

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Keywords

  • Major acute cardiovascular events
  • Photoselective vaporization of the prostate
  • BPH
  • Cardiovascular safety
  • Transurethral surgery of the prostate
  • Green light laser