Percutaneous Patent Foramen Ovale Closure in Patients with Cryptogenic Stroke or Transient Ischemic Attack: A Retrospective Study.

Yuan Liu,Quanquan Zhang,Juehua Zhu,Tan Li,Caiming Zhao,Yongming He,Qi Fang,Pinjing Hui,Vida Demarin

doi:10.1155/2022/2614225

Abstract

Background Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS). Transcatheter closure of PFO is superior to pharmacotherapy for patients with CS or transient ischemic attack (TIA). More evidence is needed to evaluate the efficacy and safety of PFO closure in Chinese patients. Methods This study enrolled ten CS patients and two TIA patients (mean age of 40.8 ± 9.7 y), including seven males (58%) and five females (42%) who underwent PFO closure in our center from January 2017 to July 2019. Baseline data, imaging data, and RoPE (Risk of Paradoxical Embolism) score were collected retrospectively. The preprocedural assessment and percutaneous transcatheter PFO closure were described in detail. The perioperative complications and follow-ups were recorded from all patients. Results Among ten patients with CS, eight patients had a RoPE score of >6 and two patients had a RoPE score of 6. MRI confirmed multiple infarcts in seven cases, and infarct involving the cortex in nine cases. Abnormal ECG was found in three patients and abnormal Echo in four patients. Right-to-left shunt (RLS) was detected in all the patients by cTCD or cTTE. To be specific, RLS was observed in nine of the ten TEE-detected patients. No case had PFO complicated with atrial septal aneurysm (ASA). The success rate of PFO closure was 91.6%. No serious perioperative complications were observed. During a mean time of 26.5 ± 8 months (15-41 months) of follow-up, no recurrent cerebral infarction, TIA, or thromboembolism were detected in postoperative patients. Conclusions PFO closure is safe and effective in the treatment of Chinese patients with CS or TIA.

Highlights

Cryptogenic stroke (CS) refers to the ischemic stroke that occurs in 30%-40% of patients with an unclear etiology [1–3]
This retrospective study indicates that the closure of Patent foramen ovale (PFO) is safe and easy to perform in patients with cryptogenic stroke (CS) or transient ischemic attack (TIA)
The key point is that the overall evaluation should be performed in all of the patients, which will be helpful to identify CS or TIA related to PFO before the intervention

Summary

Introduction

Cryptogenic stroke (CS) refers to the ischemic stroke that occurs in 30%-40% of patients with an unclear etiology [1–3]. Multiple trial-level metaanalyses have confirmed the efficacy of closure for stroke prevention [9]. Patients with transient ischemic attack (TIA) should be assessed precisely to exclude a mimic before referring for PFO closure. A few observational studies have been reported [10, 11], more evidence is needed to evaluate the efficacy. Transcatheter closure of PFO is superior to pharmacotherapy for patients with CS or transient ischemic attack (TIA). More evidence is needed to evaluate the efficacy and safety of PFO closure in Chinese patients. This study enrolled ten CS patients and two TIA patients (mean age of 40:8 ± 9:7 y), including seven males (58%) and five females (42%) who underwent PFO closure in our center from January 2017 to July 2019. PFO closure is safe and effective in the treatment of Chinese patients with CS or TIA

Methods

Results

Conclusion