Transcatheter closure of patent foramen ovale (PFO) in patients with paradoxical embolism: periprocedural safety and mid-term follow-up results of three different device occluder systems

Braun, Martin; Gliech, V.; Boscheri, Alessandra

doi:10.1016/j.accreview.2004.06.029

Cited by 34 publications

(74 citation statements)

References 20 publications

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“…By contrast, after VM, 14 (70%) showed RLS after the procedure. Despite differences in the methodology, Harms et al 7 , in 236 patients, and Braun et al 6 demonstrated RLS in almost 44% of patients after the procedure. Notably in our data, only six patients (30%) showed no MES at rest and after VM, and surgery was performed in Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, this has led to an increase in the number of procedures performed worldwide and the emergence of different devices 2,3,5,6,8,9,16 . Despite these promising results, some cautious recommendations for PFO closure criteria have been recently established.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated that RLS emboli and PFO are significantly associated with cryptogenic ischemic stroke, transient ischemic attack (TIA) and migraine with aura in young adults (below 55 years of age) [2][3][4][5] . Prevention against further embolic events by PFO closure is a controversial issue, however the procedure is indicated in some restricted cases [6][7][8][9][10][11][12][13] . The aim of this study was to certify whether or not the PFO method of closure confirmed by transcranial Doppler prevented microemboli after a minimum of 12 months.…”

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confidence: 99%

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Is the patent foramen ovale closure the best option?

Zétola

Silva

Lange

et al. 2012

Arq. Neuro-Psiquiatr.

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Patent foramen ovale (PFO) is a congenital heart disease remnant of fetal circulation. The flap of the foramen ovale (septum primum) closes against the atrial septum (septum secundum) and normally fuses within the first two years of life. If the septum secundum covers the oval foramen, but does not seal to the septum primum, then a probable PFO exists that can be "opened" by the Valsalva or other maneuvers that increase right atrial pressure 1,2 . Prevalence of incomplete fusion is approximately 25-27% 1,3 and is associated with atrial septum aneurysm (ASA) in 50-80% patients in a global population 3 . The opening between the left and right atria can introduce venous blood or venous thrombus to the arterial system by crossing into the left heart through a right-to-left shunt (RLS) [1][2][3][4][5] . Studies have demonstrated that RLS emboli and PFO are significantly associated with cryptogenic ischemic stroke, transient ischemic attack (TIA) and migraine with aura in young adults (below 55 years of age) [2][3][4][5] . Prevention against further embolic events by PFO closure is a controversial issue, however the procedure is indicated in some restricted cases [6][7][8][9][10][11][12][13] . The aim of this study was to certify whether or not the PFO method of closure confirmed by transcranial Doppler prevented microemboli after a minimum of 12 months. ABSTRACT Patent foramen ovale (PFO) closure is indicated in some cases to protect patients against embolic events. The aim of this study was to certify that the method of PFO closure to prevent microemboli (MES) is reliable, using contrast enhanced transcranial Doppler (cTCD) as a diagnostic and follow-up tool. Methods: cTCD was performed before and after PFO closure in 20 patients. Results obtained a minimum of 12 months after the procedure were analyzed in this study. Results: After the procedure, 14 patients (82%) showed no microemboli in cTCD at rest, but after provocative Valsalva maneuver (VM) microembolic phenomenon were still detected in 14 (70%): 7 (35%) <10 MES, 3 (15%) 10-20 MES and 4 (20%) had more than 20 MES ("curtain"). Only six of the total patients presented no MES in both resting and VM. Conclusion: These results showed a large percentage of patients with MES detection in a bubble study with transcranial Doppler more than one year after the procedure of PFO closure, showing right-to-left residual shunting. Despite the small number of patients, this study provides important data about this therapeutic decision.Key words: foramen ovale, patent, ultrasonography, Doppler, transcranial, embolism, treatment. RESUMOO fechamento do forame oval patente (FOP) é indicado em alguns casos para prevenir eventos embólicos. O objetivo deste estudo foi certificar que o fechamento do FOP previne contra microembolia usando o Doppler transcraniano contrastado (cTCD) como método diagnóstico e de controle. Métodos: O cTCD foi realizado antes e depois do fechamento do FOP em 20 pacientes. Foram analisados somente os resultados obtidos após 12 meses do procedimento. Resulta...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Is the patent foramen ovale closure the best option?

Zétola

Silva

Lange

et al. 2012

Arq. Neuro-Psiquiatr.

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“…As reported in previous publications by our group, we performed systematic coronary angiography in patients undergoing percutaneous PFO closure aged CARDIOVASCULAR MEDICINE -KARDIOVASKULÄRE MEDIZIN -MÉDECINE CARDIOVASCULAIRE 2016;19(1): [19][20][21][22][23][24] >50 in males and >60 in females. In this study, a rather high proportion of the examined patients (29%) presented with unsuspected coronary artery disease, justifying incidental coronary angiography in selected patients.…”

Section: Percutaneous Pfo Closurementioning

confidence: 99%

“…Intraprocedural guidance by TOE [17][18][19] or intracardiac echocardiography [20,21] was not used in any case. However, all patients had undergone contrast TOE for initial diagnosis of PFO prior to the intervention.…”

Section: Percutaneous Pfo Closurementioning

confidence: 99%