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经皮卵圆孔未闭封堵术应用 HELEX® 房间隔封堵器:405 例患者的即刻和长期疗效。

Percutaneous closure of the patent foramen ovale using the HELEX® Septal Occluder: acute and long-term results in 405 patients.

机构信息

CardioVascular Center, Frankfurt, Germany.

出版信息

EuroIntervention. 2012 Oct;8(6):717-23. doi: 10.4244/EIJV8I6A111.

Abstract

AIMS

Although routinely used, limited data are available regarding the long-term outcome after patent foramen ovale (PFO) closure using the HELEX® Occluder system. The aim of this study was therefore the examination of the acute and long-term outcome after transcatheter PFO closure using this system.

METHODS AND RESULTS

All (n=407) patients included had undergone PFO closure with the HELEX® Occluder system for secondary prevention of stroke, transient ischaemic attack (TIA) or peripheral embolism at a single centre. Primary endpoints were residual shunts at six or 12 months (assessed by transoesophageal echocardiography) and the number of neurological and other adverse events during follow-up. Device implantation was successful in 99% of patients. Complete closure at six months was achieved in 81%. During follow-up of 1,695 patient-years, 10 neurologic events occurred (four TIA, six strokes). The annual incidence of stroke was 1.2%. Other adverse events were wire frame fractures requiring no further intervention in five (1%), device-associated thrombus formation in one (0.25%), and paroxysmal atrial fibrillation in nine patients (2%).

CONCLUSIONS

PFO closure using the HELEX® Occluder system is feasible and safe. Complications and adverse events during long-term follow-up are rare. The safety profile and efficacy in prevention of recurrent events compare well to that reported with other closure devices.

摘要

目的

尽管卵圆孔未闭(PFO)封堵术(HELEX® Occluder 系统)已被常规应用,但有关其长期预后的数据有限。因此,本研究旨在探讨应用该系统行经导管 PFO 封堵术的即刻和长期预后。

方法和结果

所有(n=407)患者均在单一中心因中风、短暂性脑缺血发作(TIA)或外周栓塞的二级预防而行 PFO 封堵术,采用 HELEX® Occluder 系统。主要终点为术后 6 个月或 12 个月时残余分流(经食管超声心动图评估)和随访期间神经和其他不良事件的数量。99%的患者成功植入了封堵器。6 个月时完全封堵率为 81%。在 1695 患者年的随访期间,发生了 10 例神经系统事件(4 例 TIA,6 例中风)。中风年发生率为 1.2%。其他不良事件包括 5 例(1%)需要进一步干预的线框骨折、1 例(0.25%)与器械相关的血栓形成和 9 例(2%)阵发性心房颤动。

结论

应用 HELEX® Occluder 系统行 PFO 封堵术是可行和安全的。长期随访期间并发症和不良事件罕见。预防复发事件的安全性和疗效与其他封堵器报道的结果相当。

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