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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

317
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
317
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

396
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Related Experiment Video

Updated: May 7, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Steerable Delivery Sheath for Optimized LAA Closure: First Experience and Procedural Outcomes.

Matthias Mezger1,2, Christina Paitazoglou1,2, Christian Frerker1,2

  • 1Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Lübeck, Germany.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 31, 2024
PubMed
Summary

The Amplatzer Steerable Delivery Sheath offers a feasible and safe approach for left atrial appendage closure (LAAC). While initial use showed a learning curve, procedural success rates remained high, indicating its potential for improved LAAC procedures.

Keywords:
LAA occlusionanticoagulationatrial fibrillationbleedingdelivery sheath

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Left atrial appendage closure (LAAC) is crucial for stroke prevention in patients with atrial fibrillation.
  • The Amplatzer Amulet device is widely used for LAAC.
  • Delivery system advancements aim to enhance LAAC procedure efficiency and outcomes.

Purpose of the Study:

  • To compare procedural outcomes of LAAC using the Amulet device with the new Amplatzer Steerable Delivery Sheath versus the standard sheath.
  • To evaluate the feasibility, safety, and learning curve associated with the steerable sheath.

Main Methods:

  • A retrospective analysis of 32 patients treated with the steerable sheath and 39 control patients treated with the standard sheath.
  • Both groups received LAAC with the Amulet device.
  • Procedural success, contrast use, fluoroscopy time, and complication rates were assessed.

Main Results:

  • 100% LAAC success rate in both steerable sheath and control groups.
  • Numerically higher contrast use and fluoroscopy time in the steerable sheath group, suggesting an initial learning curve.
  • High complete sealing rates (97% vs. 95%) and low periprocedural complication rates in both groups.

Conclusions:

  • LAAC with the Amplatzer Amulet steerable delivery sheath is feasible and safe.
  • The steerable sheath demonstrates a learning curve, with potential for future procedural optimization.
  • The device shows promise for improving LAAC procedures.