Transcatheter closure of patent foramen ovale in patients with cerebral ischemia

Braun, Martin; Fassbender, D; Schoen, Steffen; Haass, Markus; Schraeder, Rainer; Scholtz, Werner; Strasser, Ruth H.

doi:10.1016/s0735-1097(02)01904-6

Cited by 179 publications

(130 citation statements)

References 18 publications

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“…Optimal treatment of paradoxical embolism associated with PFO is not known, 211 but ongoing adult studies of transcatheter PFO closure may provide additional evidence that might apply to children. 212,213 Paradoxical emboli result when thrombi bypass the pulmonary circulation during right-to-left shunting. Paradoxical embolism also occurs in individuals with pulmonary arteriovenous fistula, which occurs with increased frequency in patients with hereditary hemorrhagic telangiectasia (OslerWeber-Rendu disease).…”

Section: Cardiac Diseasementioning

confidence: 99%

Management of Stroke in Infants and Children

Roach¹,

Golomb²,

Adams³

et al. 2008

Stroke

872

377

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Purpose— The purpose of this statement is to review the literature on childhood stroke and to provide recommendations for optimal diagnosis and treatment. This statement is intended for physicians who are responsible for diagnosing and treating infants, children, and adolescents with cerebrovascular disease. Methods— The Writing Group members were appointed by the American Heart Association Stroke Council’s Scientific Statement Oversight Committee. The panel included members with several different areas of expertise. Each of the panel’s recommendations was weighted by applying the American Heart Association Stroke Council’s Levels of Evidence grading algorithm. After being reviewed by panel members, the manuscript was reviewed by 4 expert peer reviewers and by members of the Stroke Council Leadership Committee and was approved by the American Heart Association Science Advisory and Coordinating Committee. We anticipate that this statement will need to be updated in 4 years. Results— Evidence-based recommendations are provided for the prevention of ischemic stroke caused by sickle cell disease, moyamoya disease, cervicocephalic arterial dissection, and cardiogenic embolism. Recommendations on the evaluation and management of hemorrhagic stroke also are provided. Protocols for dosing of heparin and warfarin in children are suggested. Also included are recommendations on the evaluation and management of perinatal stroke and cerebral sinovenous thrombosis in children.

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Section: Cardiac Diseasementioning

confidence: 99%

Management of Stroke in Infants and Children

Roach¹,

Golomb²,

Adams³

et al. 2008

Stroke

872

377

View full text Add to dashboard Cite

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“…28,29 However, there are patients without a residual shunt who have recurrent neurologic symptoms. 30 It is possible in these cases that thrombus formed on the left side of the device, producing embolic events before the device surface was completely endothelialized. These TEE observations may be visualizing a part of the natural healing process, in which thrombus evolves into a fibrous scar.…”

Section: Discussionmentioning

confidence: 99%

Incidence of thrombus formation on the CardioSEAL and the Amplatzer interatrial closure devices

Anzai

Child

Natterson

et al. 2004

The American Journal of Cardiology

134

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“…A prothrombotic state was determined on the basis of positive hypercoagulable laboratory workup results or a clinical predisposition such as malignancy or hormone replacement therapy. 7 A total of 131 patients (52.0%) underwent percutaneous PFO closure. PFO closure was not performed for MH.…”

Section: Methodsmentioning

confidence: 99%

Five-Year Experience With Percutaneous Closure of Patent Foramen Ovale

Slavin

Tobis

Rangarajan

et al. 2007

The American Journal of Cardiology

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Patent foramen ovale (PFO) has been implicated in the pathogenesis of cryptogenic stroke, arterial desaturation, decompression illness, and migraine headache (MH). This study evaluated the safety of percutaneous transcatheter PFO closure in patients with cryptogenic stroke, transient ischemic attack, or arterial desaturation. Additionally, symptomatic reduction in MH was determined after interatrial shunt closure. Of the 252 patients referred to the University of California, Los Angeles, with PFO, 131 underwent closure of the interatrial communication with a CardioSEAL (n ‫؍‬ 30) or Amplatzer (n ‫؍‬ 101) device. PFO morphology was evaluated with transesophageal echocardiography. Follow-up was conducted at 1 to 2 months with echocardiography, with clinical assessment annually thereafter. At an average follow-up of 30 months, there was no recurrence of any thromboembolic event (transient ischemic attack, stroke, or peripheral). There was a reduction in MH, defined as the complete resolution of headache or a >50% reduction in the number of headache days, in 85% of patients after PFO closure. Temporary problems after device implantation, including chest discomfort and palpitations, were reported in 23% of patients and occurred more frequently in patients with nickel hypersensitivity (p <0.05). In conclusion, transcatheter PFO closure is an effective and safe therapeutic modality in the prevention of thromboembolic events and MH associated with interatrial shunting in patients who present with cryptogenic stroke. Pending randomized, controlled trials are necessary to determine if this invasive approach is preferable to medical therapy for the prevention of recurrent stroke or as primary treatment for patients with MH.

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Transcatheter closure of patent foramen ovale in patients with cerebral ischemia

Cited by 179 publications

References 18 publications

Management of Stroke in Infants and Children

Management of Stroke in Infants and Children

Incidence of thrombus formation on the CardioSEAL and the Amplatzer interatrial closure devices

Five-Year Experience With Percutaneous Closure of Patent Foramen Ovale

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