Long-term follow-up after percutaneous closure of patent foramen ovale with Amplatzer PFO Occluder: a single center experience
Long-term follow-up after percutaneous closure of patent foramen ovale with Amplatzer PFO Occluder: a single center experience
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DOI：
10.5114/pwki.2016.56949
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发表时间：
2016-03-01
影响因子：
1.3
通讯作者：
Grajek, Stefan
中科院分区：
文献类型：
--
作者：
Araszkiewicz, Aleksander;Grygier, Marek;Grajek, Stefan
简介：卵圆孔未闭（PFO）与隐源性中风、短暂性神经系统缺血发作（TIA）和偏头痛的发生有关。因此，尽管最近的前瞻性对照试验结果不明确，但经皮PFO闭合术仍在许多中心进行。目的：通过长期观察，评价经皮PFO闭合术在预防神经系统事件和偏头痛症状复发方面的安全性和有效性。（31名男性，年龄：38 - 18岁）使用Amplatzer PFO封堵器成功进行了经皮PFO封堵术。在所有患者的神经系统随访进行了采访，以揭示复发的栓塞，如TIA或中风和偏头痛症状的存在之前和之后的procedure.Results：平均随访期为857 - 363天（中位数：571天）。未观察到严重的手术并发症和死亡。5例（7.1%）患者发生神经系统事件，1例患者发生卒中，3例患者发生TIA，1例患者发生眼栓塞。所有这些患者都超过40岁或有其他心血管危险因素。术前21例（30%）患者发生偏头痛，术后11例（15.7%）发生偏头痛（P = 0.04）。结论：年轻患者PFO封堵术后神经系统并发症发生率和复发率较低。然而，仔细的资格和术后监测的病人是必要的。卵圆孔未闭闭合似乎可以减轻偏头痛症状。
Introduction: Patent foramen ovate (PFO) is associated with the occurrence of cryptogenic strokes, transient neurological ischemic attacks (TIA) and migraine. Therefore despite the recent ambiguous results of prospective controlled trials, percutaneous closure of PFO is still performed in many centers.Aim: To evaluate the safety and effectiveness of percutaneous PFO closure in the prevention of recurrence of neurologic events and migraine symptoms in long-term observation.Material and methods: In 70 patients (31 male, age: 38 18 years) percutaneous PFO closure was successfully performed with the Amplatzer PFO Occluder. An interview in conjunction with neurological follow-up was performed in all patients to reveal recurrence of embolism such as TIA or stroke and the presence of migraine symptoms before and after the procedure.Results: The mean follow-up period was 857 363 days (median: 571 days). No serious complications of the procedure and no death were observed. Neurological events recurred in 5 (7.1%) patients stroke in 1 patient, TIA in 3 patients, ocular embolism in 1 patient. All of these patients were over 40 years old or had other cardiovascular risk factors. Migraine was observed in 21 (30%) patients before the procedure and in 11 (15.7%) after the procedure (p = 0.04).Conclusions: The complication rate and recurrence of neurological events in young patients after PFO closure are low. However, careful qualification and postprocedural monitoring of the patients are necessary. Patent foramen ovate closure seems to result in attenuation of migraine symptoms.