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Intermediate and Long-Term Results of Transcatheter Closure of Patent Foramen Ovale Using the Amplatzer Patent Foramen Ovale Occluder: One Case of Pulmonary Embolism Irrespective of Patent Foramen Ovale Closure
Korean Circulation Journal ; : 356-362, 2011.
Article en En | WPRIM | ID: wpr-85774
Biblioteca responsable: WPRO
ABSTRACT
BACKGROUND AND OBJECTIVES: Patent foramen ovale (PFO) has been implicated in the pathogenesis of cryptogenic stroke or transient ischemic attack (TIA) due to paradoxical embolism, and in the pathogenesis of migraine. This paper reports the intermediate and long-term results of transcatheter closure of PFO associated with cerebrovascular accidents (CVAs), TIAs and migraine, using the Amplatzer PFO occluder. This paper also reports a case of pulmonary embolism which developed in one patient after PFO closure. SUBJECTS AND METHODS: From January 2003 to May 2010, 16 patients with PFO (seven males and nine females) with a history of at least one episode of cryptogenic stroke/TIA, CVA, or migraine and who underwent percutaneous transcatheter closure of PFO using the Amplatzer occluder. All the procedures were performed under general anesthesia and were assisted by transesophageal echocardiography. RESULTS: The device was implanted without any significant complications in all the patients, and the PFOs were effectively closed. At an average follow-up period of 54 months, the 15 patients with TIA/CVA had no recurrence of any thromboembolic event. The symptoms in one patient with migraine subsided after occlusion of the PFO. In this study, pulmonary embolism occurred five months after PFO closure in one patient, but the cause of pulmonary embolism was not identified. However, it is believed that the pulmonary embolism occurred without stroke recurrence because occlusion of the PFO was performed when the patient had a stroke event. CONCLUSION: It can be concluded that according to the intermediate and long-term follow-up results, transcatheter PFO closure is an effective and safe therapeutic modality in the prevention of thromboembolic events, especially in the patients with cryptogenic stroke/TIA, and PFO closure is helpful in the treatment of migraine. However, this study involved a small number of patients and also the follow-up period was not long enough. Hence, randomized, controlled trials are necessary to determine if this approach is preferable to medical therapy for the prevention of recurrent stroke or as primary treatment for patients with migraine headache.
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Texto completo: 1 Base de datos: WPRIM Asunto principal: Embolia Pulmonar / Recurrencia / Ataque Isquémico Transitorio / Estudios de Seguimiento / Embolia Paradójica / Accidente Cerebrovascular / Foramen Oval Permeable / Dispositivo Oclusor Septal / Anestesia General / Trastornos Migrañosos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Humans / Male Idioma: En Revista: Korean Circulation Journal Año: 2011 Tipo del documento: Article
Texto completo: 1 Base de datos: WPRIM Asunto principal: Embolia Pulmonar / Recurrencia / Ataque Isquémico Transitorio / Estudios de Seguimiento / Embolia Paradójica / Accidente Cerebrovascular / Foramen Oval Permeable / Dispositivo Oclusor Septal / Anestesia General / Trastornos Migrañosos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Humans / Male Idioma: En Revista: Korean Circulation Journal Año: 2011 Tipo del documento: Article