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

Int Urol Nephrol. 2018 Nov;50(11):1955-1962. doi: 10.1007/s11255-018-1968-9. Epub 2018 Aug 23.


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.

Keywords: BPH; Cardiovascular safety; Green light laser; Major acute cardiovascular events; Photoselective vaporization of the prostate; Transurethral surgery of the prostate.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / etiology*
  • Humans
  • Intraoperative Complications / etiology*
  • Laser Therapy / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Prostatic Hyperplasia / surgery*
  • Retrospective Studies
  • Transurethral Resection of Prostate / adverse effects*