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Percutaneous PFO closure for cryptogenic stroke in young adults: A single-center experience
Inês Macedo Conde1, Rodrigo Silva1, Carlos Resende Galvão2
1Cardiology Department, Hospital de Braga, Braga, Portugal.
Insights
Percutaneous closure of patent foramen ovale (PFO) is safe and effective for preventing cryptogenic stroke recurrence in carefully selected patients. This single-center study achieved 100% procedural success and closure rates.
Area of Science:
- Cardiology
- Neurology
- Interventional Cardiology
Background:
- Patent foramen ovale (PFO) closure is supported by RCTs for cryptogenic stroke prevention.
- Young patients with high-risk PFO or paradoxical embolism factors benefit most.
- Single-center experience offers practical insights into PFO closure procedures.
Purpose of the Study:
- To describe the center's experience with percutaneous PFO closure in cryptogenic stroke patients.
- To evaluate the short-term clinical outcomes of PFO closure.
- To assess patient selection, technical aspects, and outcome monitoring.
Main Methods:
- Observational, retrospective study.
- Included 62 patients with cryptogenic stroke evaluated for PFO closure (Feb 2021-Feb 2024).
- 32 patients underwent percutaneous PFO closure using specific occluder devices.
Main Results:
- 51.6% of evaluated patients were selected for PFO closure.
- 100% acute procedural success rate with no major complications.
- 100% closure rate observed at 6 and 12 months post-procedure.
Conclusions:
- Careful patient selection and multidisciplinary management are crucial for optimal PFO closure outcomes.
- Percutaneous PFO closure is a safe and effective intervention in selected cryptogenic stroke patients.
- Further research is needed to refine selection criteria and explore long-term benefits.
Background And Aim:
Randomized controlled trials support patent foramen ovale (PFO) percutaneous closure for the prevention of cryptogenic stroke recurrence, particularly in young patients with high-risk PFO or other predisposing factors for paradoxical embolism. Our single-center experience provides valuable insights into the practical aspects of this procedure, including patient selection, technical considerations, and outcome monitoring. Our goal was to describe our center's experience with the percutaneous closure of PFO in patients presenting with cryptogenic stroke, as well as to evaluate the short-term clinical results.
Methods:
Observational, retrospective study including 62 patients with cryptogenic stroke evaluated for PFO closure between February 2021 and February 2024.
Results:
Of the 62 patients evaluated, 32 (51.6%) were deemed appropriate for closure based on clinical and anatomical characteristics. These patients underwent percutaneous PFO closure, using Amplatzer™ Talisman™ PFO Occluder Abbott Cardiovascular USA, Amplatzer™ Cribriform Occluder Abbott or Amplatzer™ Talisman™ PFO Occluder Abbott Cardiovascular USA. A 100% acute procedural success rate was achieved, with no major complications. At 6 and 12 months, a 100% closure rate was observed.
Conclusions:
Our findings highlight the importance of careful patient selection and multidisciplinary management to optimize outcomes, demonstrating that percutaneous PFO closure is a safe and effective intervention in selected patients. Further research is needed to refine patient selection criteria and to explore the long-term benefits of PFO closure in diverse patient populations.
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