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Research Article

EJCM. 2014; 2(1): 3-8


Percutaneous transcatheter closure of patent foramen ovale in patients with paradoxical embolism

Francesco Pollice; Paolo Pollice; Lyan Jacob.

Abstract
Aim: Cryptogenic stroke remains the final diagnosis in 40% of ischemic acute cerebrovascular events. Until now there are no clinical evidences that the percutaneous closure of PFO is able to prevent the recurrence of stroke or transient ischemic attack (TIA). The aim of this study was to evaluate the incidence of recurrence in patients successfully. Treated by percutaneous closure of PFO with different occlude devices by using TDC, TTE and clinical evaluation.
Material and Method: From June 2004 to February 2010, 72 PTS, (40 females and 32 males; everage age 46 yrs, range 14-66), admitted with diagnosis of recurrent ischemic neurologic events (58 stroke and 14 TIA)underwent percutaneous closure of PFO. Thirty-one (43%) of the 72 patients had a concomitant history of migraine, 16(52%) of whom with aura. Five different occlude devices were used, with a total amount of 74 implants. All pts were studied during the follow-up by clinical evaluation (Rankin modified scale), TCD and TTE.
Results: Successful device deployment is achieved in 100% of pts without any periprocedural major complication. Only in two pts atrial arrhythmia have occurred. All pts was discharged within 3 days in good overall conditions. In all pts a double antiplatelet regimen was adopted. The follow-up was complete in 100% of the cases (median 30, range 3-58 months). At five years, there was no recurrent stroke or TIA, and no new cerebral lesions developed by MRI in those patients with residual shunt. Moreover, in 65 (90%)of them the Rankin scale significantly (P

Key words: aging population ; cardiovascular events ; elderly people ; Hypertension ; stroke



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