Long term follow up after percutaneous closure of PFO in 357 patients with paradoxical embolism: Difference in occlusion systems and influence of atrial septum aneurysm

Bardeleben, Ralph Stephan von; Richter, Claudia; Otto, Julia; Himmrich, Ludmilla; Schnabel, Renate B.; Kampmann, Christoph; Rupprecht, Hans‐Jürgen; Marx, Jürgen; Hommel, Gerhard; Münzel, Thomas; Horstick, Georg

doi:10.1016/j.ijcard.2008.02.031

Cited by 76 publications

(58 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The device is currently under evaluation in a RCT evaluating its efficacy versus medical therapy for prevention of recurrent cerebrovascular events (the Gore REDUCE Clinical Study NCT00738894). Some observational data do suggest a higher rate of residual shunting with this device compared to other occlusion devices [46,54], while others have shown no difference [50].…”

Section: Amplatzer Pfo Occluder (St Jude Medical)mentioning

confidence: 71%

“…Multiple series have reported closure using various devices, with reported total complication rates excluding atrial fibrillation of between 0 % and 2 % [45,49,50]. The device-related adverse event rate in the RESPECT trial was 4.2 % [9•], and in the PC trial, a periprocedural complication was reported in 1.5 % of patients [8•].…”

Section: Contraindications/ Complicationsmentioning

confidence: 99%

“…The STARFlex device that was associated with increased incidence of atrial fibrillation in the CLOSURE 1 trial [7•] has also been associated with serious thrombotic complications and is unlikely to be used in the future [50,53].…”

Section: Potential Devicesmentioning

confidence: 99%

“…The device is non-absorbable. The Amplatzer PFO occluder was the device used in both the PC [8•] and RESP ECT trials [9•], and has shown reproducibility, an acceptable side effect profile, and a low residual shunt rate in observational studies [45,46,49,50,53,54]. Another trial evaluating the Amplatzer PFO occluder is ongoing (DEFENSE-PFO NCT01550588).…”

Section: Amplatzer Pfo Occluder (St Jude Medical)mentioning

confidence: 99%

See 3 more Smart Citations

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

Roth

Alli

2015

Curr Treat Options Neurol

View full text Add to dashboard Cite

Patent foramen ovale (PFO) has been linked to stroke, presumably through the mechanism of paradoxical embolism; however, data is confusing regarding the causal relationship between PFO and embolic stroke. What has come to light in the past decade of research is that PFO closure with devices that achieve a high rate of closure may reduce the risk of recurrent stroke compared with medical therapy, but this benefit has not been shown in the general population with a PFO and cryptogenic stroke. The important question now is which patient will benefit from PFO closure for stroke risk reduction. A validated risk prediction tool is needed to help physicians determine those patients who will derive benefit from closure of PFO to prevent recurrent stroke. It is clear that even in studies with a small number of individuals and a very small number of events, there is some benefit to closure. Furthermore, improvements in closure devices and techniques have made percutaneous device closure both safe and efficacious. As such, it is not necessary to wait for a patient to have two strokes prior to serious consideration of PFO closure. We would advocate that the decision to close a PFO in the setting of a cryptogenic stroke be made at an individual level, on a case-by-case basis. Patients with high-risk features may be more likely to benefit, though who exactly comprises this population is still being elucidated. The most difficult aspect of managing this disease is the substantial number of individuals with incidental PFOs, as well as the prevalence of stroke due to other etiologies. When treating this disease, the physician must be able to weigh the likelihood of benefit versus the risk of the procedure, as well as patient preference.

show abstract

Section: Amplatzer Pfo Occluder (St Jude Medical)mentioning

confidence: 71%

Section: Contraindications/ Complicationsmentioning

confidence: 99%

Section: Potential Devicesmentioning

confidence: 99%

Section: Amplatzer Pfo Occluder (St Jude Medical)mentioning

confidence: 99%

See 2 more Smart Citations

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

Roth

Alli

2015

Curr Treat Options Neurol

View full text Add to dashboard Cite

show abstract

“…These 2 closure systems are reported to be the safest and most efficacious devices in terms of periprocedural complications, incidence of recurrence of neurological TE, residual shunt at follow-up and rate of thrombus formation, thus underlining the importance of device design for successful percutaneous PFO closure. 13,31, 36 If the PFO diameter is <10 mm, a relatively small device (Amplatzer device 18 mm, Spider device 16 mm) can be selected. If the PFO diameter exceeds 20 mm or trans-septal puncture is required, a relative larger device (Amplatzer device 35 mm, Spider device 24 or 26 mm) will be needed.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Patent Foramen Ovale in Chinese Patients With Paradoxical Embolism - Immediate Results and Long-Term Follow-up -

Zhang

Huang

et al. 2011

Circ J

View full text Add to dashboard Cite

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp atent foramen ovale (PFO) is an anatomical variant of the interatrial septum with an overall prevalence of 27% in autopsy studies. 1 PFO has been associated with cryptogenic stroke and migraine headaches, 2-4 and increasingly recognized as a source of paradoxical embolism. A high prevalence of PFO has been reported in approximately 50% of patients with cryptogenic transient ischemic attack (TIA) or ischemic stroke, 2 suggesting an association between the presence of PFO, with or without atrial septal aneurysm (ASA), and thromboembolic events (TE). 5 The optimal management for the prevention of a paradoxical embolic event in these patients remains controversial. Medical therapies with anticoagulants or antiplatelet agents, surgical PFO closure and percutaneous transcatheter closure of the PFO have been proposed as therapeutic options. 6 The results of several randomized clinical trials, randomized controlled trials and reports of single-center experience have indicated that transcatheter PFO closure is a potential option for patients with PFO and thromboembolic phenomena, in that it avoids the morbidity associated with surgical closure or lifelong anticoagulation therapy. 4,7-10 Despite the good short-term results of transcatheter PFO closure in these patients, however, the long-term data are limited, especially in Chinese patients. The aim of the present study was therefore to assess the long-term clinical outcome in PFO patients with paradoxical embolism who underwent transcatheter PFO closure in a single center. Methods PatientsBetween January 2005 and May 2010, 192 patients who were referred for transcatheter closure of a PFO following 1 or more presumed paradoxical systemic events were included in the present study. A TE was considered to be due to a paradoxical embolism when the following criteria were met: presence of PFO with spontaneous or provocable right-to-left shunt during transthoracic echocardiography (TTE)/trans-

show abstract

Thrombosis, fracture, and percutaneous removal of a patent foramen ovale closure device 1 month after successful deployment

Gori¹,

Schräder²,

Genth-Zotz³

2010

Cathet Cardio Intervent

View full text Add to dashboard Cite

Several different devices have been developed for the percutaneous closure of interatrial defects and patent foramen ovale. Although the implantation of these devices is both safe and effective, a number of complications, both in the early and the late follow-up, may occur. We describe a case of device fracture manifested early (1 month after implantation) with the formation of massive thrombosis on the right atrial disc. The patient was treated with anticoagulants and the device was percutaneously retrieved. Our images allowed early noninvasive therapy and emphasize the need for echocardiographic follow-up early after implantation.

show abstract

Long term follow up after percutaneous closure of PFO in 357 patients with paradoxical embolism: Difference in occlusion systems and influence of atrial septum aneurysm

Cited by 76 publications

References 50 publications

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

Role of Occlusive Devices to Prevent Thromboembolism Among Persons With a Patent Foramen Ovale and Prior Stroke

Transcatheter Closure of Patent Foramen Ovale in Chinese Patients With Paradoxical Embolism - Immediate Results and Long-Term Follow-up -

Thrombosis, fracture, and percutaneous removal of a patent foramen ovale closure device 1 month after successful deployment

Contact Info

Product

Resources

About