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新型卵圆孔未闭封堵装置Nit-Occlud®在中风或短暂性脑缺血发作患者中的初步经验。

Initial experience with the novel patent foramen ovale occlusion device Nit-Occlud® in patients with stroke or transient ischemic attack.

作者信息

Steinberg Daniel H, Bertog Stefan C, Momberger Julia, Franke Jennifer, Hofmann Ilona, Renkhoff Kristina, Joy Sonya, Vaskelyte Laura, Sievert Horst

机构信息

Medical University of South Carolina, Charleston, South Carolina.

CardioVascular Center Frankfurt, Frankfurt, Germany.

出版信息

Catheter Cardiovasc Interv. 2015 Jun;85(7):1262-7. doi: 10.1002/ccd.25580. Epub 2015 Apr 2.

Abstract

BACKGROUND

Patent foramen ovale (PFO) is associated with cryptogenic strokes and transient ischemic attacks (TIAs). This study examined the initial experience with a new PFO occluder, the Nit-Occlud® PFO Occlusion Device.

METHODS

Sixty-three patients with history of cryptogenic stroke or TIA and PFO underwent percutaneous closure of the defect with the Nit-Occlud® PFO Occlusion Device. The primary endpoint was successful implantation without recurrent event, device malfunction, embolization, or the need for a replacement device over 6 ± 2 weeks. All patients underwent transesophageal echocardiography (TEE) at 6-weeks, and 42 patients had repeat TEE at 6-months. Clinical follow-up at 18.7 ± 7.4 months was also performed.

RESULTS

The device was successfully implanted in 62 (98.4%) patients with no relevant procedural complications. At 6-week follow-up, 60 (95.2%) patients met the primary endpoint. A residual shunt at rest and with Valsalva was noted in 8 (12.7%) and 31 (49.2%) patients respectively at 6-week TEE. At 6-months, 1 of 42 (2.4%) and 9 of 42 (21.4%) patients had a residual shunt at rest and with Valsava, respectively. At 18 months, 5/63 patients had recurrent events (3 TIAs, 2 strokes). No device-related complications occurred. One patient developed atrial fibrillation.

CONCLUSION

In patients with cryptogenic stroke or TIA and a PFO, the Nit-Occlud® PFO Occlusion Device appears to be both a safe and effective means to occlude the PFO. It is associated with high procedural success and favorable rates of complete closure.

摘要

背景

卵圆孔未闭(PFO)与不明原因的卒中及短暂性脑缺血发作(TIA)相关。本研究考察了一种新型PFO封堵器——Nit-Occlud® PFO封堵装置的初步使用经验。

方法

63例有不明原因卒中或TIA病史且存在PFO的患者接受了使用Nit-Occlud® PFO封堵装置经皮封堵缺损的治疗。主要终点为在6±2周内成功植入且无复发事件、装置故障、栓塞或更换装置的需求。所有患者在6周时接受经食管超声心动图(TEE)检查,42例患者在6个月时再次接受TEE检查。还进行了18.7±7.4个月的临床随访。

结果

62例(98.4%)患者成功植入装置,无相关手术并发症。在6周随访时,60例(95.2%)患者达到主要终点。在6周TEE检查时,分别有8例(12.7%)和31例(49.2%)患者在静息和行Valsalva动作时存在残余分流。在6个月时,42例患者中有1例(2.4%)在静息时存在残余分流,9例(21.4%)在做Valsalva动作时存在残余分流。在18个月时,63例患者中有5例出现复发事件(3次TIA,2次卒中)。未发生与装置相关的并发症。1例患者发生房颤。

结论

对于不明原因卒中或TIA且存在PFO的患者,Nit-Occlud® PFO封堵装置似乎是封堵PFO的一种安全有效的方法。它具有较高的手术成功率和良好的完全封堵率。

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