Percutaneous Patent Foramen Ovale Closure in Patients with Cryptogenic Stroke or Transient Ischemic Attack: A
Yuan Liu1,2, Yongming He3, Pinjing Hui4
1Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Insights
Patent foramen ovale (PFO) closure effectively treated Chinese patients with cryptogenic stroke (CS) or transient ischemic attack (TIA). This PFO closure procedure demonstrated a high success rate and no serious complications, preventing recurrent events.
Area of Science:
- Cardiology
- Neurology
- Interventional Medicine
Background:
- Patent foramen ovale (PFO) is a known risk factor for cryptogenic stroke (CS).
- Transcatheter PFO closure is considered superior to pharmacotherapy for CS and transient ischemic attack (TIA).
- Limited data exists on PFO closure efficacy and safety in Chinese populations.
Purpose of the Study:
- To evaluate the safety and effectiveness of percutaneous transcatheter PFO closure.
- To assess outcomes in Chinese patients diagnosed with CS or TIA.
Main Methods:
- Retrospective analysis of 12 patients (10 CS, 2 TIA) who underwent PFO closure between January 2017 and July 2019.
- Collection of baseline, imaging, and Risk of Paradoxical Embolism (RoPE) score data.
- Detailed description of preprocedural assessment, PFO closure procedure, and monitoring of perioperative complications and follow-up.
Main Results:
- The PFO closure success rate was 91.6% with no serious perioperative complications.
- All patients exhibited right-to-left shunting (RLS); 90% had RLS detected by transesophageal echocardiography (TEE).
- During a mean follow-up of 26.5 months, no recurrent cerebral infarction, TIA, or thromboembolism occurred.
Conclusions:
- Percutaneous transcatheter PFO closure is a safe and effective treatment option.
- This procedure is beneficial for Chinese patients suffering from CS or TIA.
- PFO closure significantly reduces the risk of recurrent cerebrovascular events.
Background:
Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS). Transcatheter closure of PFO is superior to pharmacotherapy for patients with CS or transient ischemic attack (TIA). More evidence is needed to evaluate the efficacy and safety of PFO closure in Chinese patients.
Methods:
This study enrolled ten CS patients and two TIA patients (mean age of 40.8 ± 9.7 y), including seven males (58%) and five females (42%) who underwent PFO closure in our center from January 2017 to July 2019. Baseline data, imaging data, and RoPE (Risk of Paradoxical Embolism) score were collected retrospectively. The preprocedural assessment and percutaneous transcatheter PFO closure were described in detail. The perioperative complications and follow-ups were recorded from all patients.
Results:
Among ten patients with CS, eight patients had a RoPE score of >6 and two patients had a RoPE score of 6. MRI confirmed multiple infarcts in seven cases, and infarct involving the cortex in nine cases. Abnormal ECG was found in three patients and abnormal Echo in four patients. Right-to-left shunt (RLS) was detected in all the patients by cTCD or cTTE. To be specific, RLS was observed in nine of the ten TEE-detected patients. No case had PFO complicated with atrial septal aneurysm (ASA). The success rate of PFO closure was 91.6%. No serious perioperative complications were observed. During a mean time of 26.5 ± 8 months (15-41 months) of follow-up, no recurrent cerebral infarction, TIA, or thromboembolism were detected in postoperative patients.
Conclusions:
PFO closure is safe and effective in the treatment of Chinese patients with CS or TIA.
