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Percutaneous PFO closure yields low complication, recurrence rates for stroke, TIA
Patients with stroke or transient ischemic attack who underwent percutaneous patent foramen ovale closure experienced few incidences of complications or recurrent events, according to results from a retrospective analysis.
Researchers evaluated the incidence of death and recurrent stroke or TIA among 301 patients who underwent PFO closure for treatment of stroke, TIA or systemic peripheral embolism at a single center between May 2004 and January 2013. The mean age of the patients was 48.6 ± 11 years, and 54% were men.
Follow-up included patient responses via mailed questionnaire or phone concerning outpatient or inpatient events after treatment that could indicate stroke or TIA, as well as whether the patient had received treatment for arrhythmia. If patients reported experiencing adverse events or receiving treatment, researchers requested documentation from the hospital or general practitioner that administered care, and also assessed results from neuroimaging when applicable.
Device implantation was successful in 99% of patients. The mean procedure time was 39.2 ± minutes. Half of the patients were discharged the same day that they underwent PFO closure. During the course of 40.2 ± 26.2 months of follow-up, two patients died; both deaths were attributed to unrelated causes. Five patients experienced recurrent stroke and nine experienced recurrent TIA. Fourteen patients developed atrial fibrillation that required treatment, and eight patients experienced minor complications, including device removal, transient ST elevation or sustained arrhythmia.
“Our study demonstrates that transcatheter closure of PFO is a safe and effective technique,” the researchers concluded. “There were very few major complications, and the closure rate was similar to that in the literature. ... Most importantly, incidence of recurrent embolic events was similar to the previous follow-up studies.” – by Adam Taliercio
Disclosure: One researcher reports serving as a proctor for Gore and St. Jude Medical.