Patent foramen ovale as the cause of recurrent embolic strokes. Case report

Self Cite

The literature review is devoted to the pathophysiology and clinical picture of migraine, targets of therapy and drugs used, and the connection between the pathogenesis of migraine with aura and patent foramen ovale is discussed. The results of clinical studies show a positive effect of endovascular patent foramen ovale closure on the course of migraine in the form of a decrease in the intensity, frequency of attacks and the number of headache-free days, as well as in some cases complete relief of the disease. Further study of the topic is promising, but requires careful study design and long-term follow-up of patients.

Section: ооо и его связь с мигреньюunclassified

Migraine and endovascular closure of patent foramen ovale as a method of its treatment: a literature review

Tereshchenko,

Merkulov

2024

Self Cite

Dynamics of residual shunt closure within one year after endovascular patent foramen ovale closure: a clinical study

Tereshchenko,

Merkulov

2024

Aim. To study 12-month dynamics of residual shunt (RS) closure after endovascular patent foramen ovale (PFO) closure.Material and methods. We analyzed the data of 80 patients who underwent endovascular PFO closure at the Chazov National Medical Research Center for Cardiovascular Diseases in the period 2018-2023. All patients underwent a full range of examinations in accordance with current clinical guidelines. The severity of RS immediately after occluder implantation, as well as after 1, 6 and 12 months post-intervention assessment was based on transesophageal echocardiogram bubble study at the control visit.Results. In the postoperative period, RS was visualized in 17,5% (n=14) of patients. Discharge was significant in 7,5% (n=6) of patients. One month after the intervention, residual significant discharge persisted in 10,0% (n=8) of patients. After 6 months, RS was visualized in 2,5% (n=2) of patients, and after 12 months, only in one patient (1,3%). The proportion of patients with RS 1 month after the intervention decreased to 42,9%, after 6 months to 85,7%, and after 12 months to 92,9% (p<0,05).Conclusion. Most patients with RS after endovascular intervention for PFO are characterized by complete endocardialization of the occluder and PFO closure within the first year.

Residual shunt after endovascular patent <i>foramen ovale</i> closure: in-hospital outcomes and clinical predictors

Tereshchenko,

Merkulov

2024

Aim. To study the in-hospital outcomes of patients with residual shunt (RS) through the occluder and identify predictors of its formation after endovascular patent foramen ovale (PFO) closure.Material and methods. We analyzed the data of 276 patients who underwent endovascular PFO closure for the period 2018-2023 at the Chazov National Medical Research Center. All patients underwent a scope of examinations that complied with clinical recommendations. RS in the postoperative period was assessed based on Transesophageal echocardiogram bubble study. Univariate regression analysis revealed RS predictors.Results. RS in the postoperative period was visualized in 50 patients, who, in terms of the incidence of in-hospital complications, were comparable to 226 patients without RS (p>0,05). Univariate regression analysis revealed the following indicators associated with postoperative RS: implantation of the Amplatzer PFO or Figulla Flex UNI occluder (odds ratio (OR) 8,87; 95% confidence interval (CI): 3,09-25,49), Chiari network (OR 8,26; 95% CI: 1,91-35,81), Olivares-Reyes class >3 interatrial septum aneurysm (OR 2,37; 95% CI: 1,27-4,43), as well as LAVi ≥34 ml/m2 (OR 4,01; 95% CI: 1,33-12,09) (p<0,05).Conclusion. The use of Amplatzer PFO or Figulla Flex UNI occluders, the presence of a Chiari network, signs of left atrium dilatation, and Olivares-Reyes class >3 aneurysm were significant RS predictors.