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EAU 2018

EAU 2018: Perioperative Major Acute Cardiovascular Events after 180-Watt Green Light Laser Photoselective Vaporization

Copenhagen, Denmark (UroToday.com)  Dr. M. Marchioni, clinical urologist from the Università Degli Studi in Chieti, Italy, presented a cohort of prostate resection patients who are at a high bleeding risk due to the inability of anticoagulant or antiplatelet drugs could not be suspended. In these patients, the gold standard treatement to reduce blood loss is 180-Watt Green Light (180-W GL) laser photoselective vaporization (PVP). Using patients from this cohort who underwent 180-W GL PVP treatment for benign prostatic hyperplasia (BPH), Dr. Marchioni and his team attempted to evaluate Major Acute Cardiovascular Events (MACE) and how these events could represent serious complications with difficult management. Particularly, the morbidity of the PVP procedure was sought to be evaluated in patients who were currently taking antiplatelet or anticoagulant medications according to their preoperative management.

Dr. Marchioni presented his findings from a multi-institutional, prospective database analysis on 923 patients who underwent 180-W GL PVP from 14 different medical centers. Of these patients, 16 (1.7%) were found to have suffered from MACE in 7 centers. Of these patients, 7 underwent standard PVP while the remaining 9 had anatomical PVP. In regard to preoperative medication treatment, 10 patients were not taking either antiplatelet or anticoagulant, 5 were taking antiplatelet, and 1 was taking anticoagulant. Though no patients needed to undergo transfusion, 3 patients reported deep venous thrombosis, 9 presented angina pectoris with general malaise and/or arrhythmia, and only 4 had an instrumental and laboratory diagnosis of myocardial infarction. 

In closing, Dr. Marchioni urged physicians to consider the possibility of MACE or MACE-like symptoms in their patients if they are to carry out 180-W GL PVP for patients with anticoagulant or antiplatelate. Additionally, this procedure may need to be repeated in the future to allow a larger patient set, as some of the 14 centers in this study may not have reported patients with MACE-like events. 


Presented by: M. Marchioni, MD Universit. Degli Studi "G.D'Annunzio", Dept. of Urology, Chieti, Italy

Co-Authors: Cindolo L.2, De Nunzio C.3, Greco F.4 , Destefanis P.5 ,Bergamaschi F. 6 , Ferrari G. 7 , Fasolis G. 8 , Palmieri F.9 , Divan C.10 , Oriti R. 11, Ruggera L. 12 , Tubaro A. 3 , Dadone C. 13, De Rienzo G. 14 , Frattini A. 15 , Mirone V. 4, Ricciardulli S. 6 , Varvello F. 8 , Voce S. 16 , Malossini G. 10 , Tuccio A. 11 , Chiodini P. 17, Ditonno P. 18 , Campobasso D. 15 , Schips L. 19

Author Information:
1. Universit. Degli Studi "G.D'Annunzio", Dept. of Urology, Chieti, Italy,
2. ASL 2 Abruzzo, Dept. of Urology, Chieti, Italy
3. "S.Andrea" Hospital, Sapienza University, Dept. of Urology, Rome, Italy,
4."Federico II" University of Napels, Dept. of Urology, Naples, Italy,
5.Azienda Ospedaliera Citt. della Salute e della Scienza di Torino, Dept. of Urology, Turin, Italy 
6. Arcispedale Santa Maria Nuova, Dept. of Urology, Reggio Emilia, Italy,
7."Hesperia" Hospital, Dept. of Urology, Modena, Italy,
8."S. Lazzaro" Hospital, Dept. of Urology, Alba, Italy,
9."Santa Maria delle Croci" Hospital, Dept. of Urology, Ravenna, Italy,
10.Rovereto Hospital, Dept. of Urology, Rovereto, Italy,
11.Ulivella e Glicini Clinic, Dept. of Urology, Florence, Italy,
12.Azienda Ospedaliera - University of Padua, Dept. of Urology, Padua, Italy,
13."Santa Croce e Carle" Hospital, Dept. of Urology, Cuneo, Italy,
14.University of Bari, Dept. of Emergency and Organ Transplantation, Urology and Andrology Unit, Bari, Italy,
15."Ercole Franchini" Hospital, Dept. of Urology, Montecchio Emilia, Italy,
16.“Santa Maria delle Croci Hospital”, Dept. of Urology, Ravenna, Italy,
17.Second University of Naples, Medical Statistics, Naples, Italy,
18.Univerisity of Bari, Dept. of Emergency and Organ Transplantation, Urology and Andrology Unit, Bari, Italy,
19. SS Annunziata Hospital, Dept. of Urology, Chieti, Italy

Written by: Zachary Valley MD, Department of Urology, University of California-Irvine at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark