Kim Minsu, Kim Sihoon, Moon Jeonggeun, Oh Pyung Chun, Park Yae Min, Shin Dong Hoon, Lee Yeong-Bae, Lee Ji Yeon, Hwang Hee Young, Kang Woong Chol
Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Cardiology, New Korea Hostipital, Gimpo-si, Gyeongggi-do, Republic of Korea.
J Interv Cardiol. 2018 Jun;31(3):368-374. doi: 10.1111/joic.12430. Epub 2017 Aug 21.
This study was sought to evaluate the effectiveness of patent foramen ovale (PFO) closure in selected patients (PFO shunt grade more than moderate) with cryptogenic stroke (CS).
Whether closure of PFO is an effective treatment for prevention of CS is still unclear.
Consecutive 158 patients (mean age: 49.9 years old, closure group: 67 patients, medication group: 91 patients) were enrolled. The primary end point was a composite of recurrent stroke and transient ischemic attack.
Baseline characteristics were similar between the two groups, except age which was younger in the closure group (47.7 ± 10.8 vs 51.9 ± 9.9, P = 0.013), and the presence of shunt at rest was more common in the closure group (35.8% vs 10.4%, P = 0.000). Procedural success was 94.0%. Over a mean follow-up of 27.8 months, a total of six primary end point, all of which were strokes, occurred only in the medication group (6.6% vs 0%, P = 0.039). Stroke-free survival rate was significantly higher in the closure group (P = 0.026) CONCLUSIONS: Our study showed that PFO closure may be an effective treatment strategy to prevent recurrent stroke or TIA for patients with CS if it is conducted in selective patients who have PFO shunt more than moderate grade.
本研究旨在评估卵圆孔未闭（PFO）封堵术对部分患有不明原因卒中（CS）患者（PFO分流等级为中度以上）的有效性。
PFO封堵术是否为预防CS的有效治疗方法仍不明确。
连续纳入158例患者（平均年龄：49.9岁，封堵组：67例患者，药物治疗组：91例患者）。主要终点为复发性卒中和短暂性脑缺血发作的复合终点。
两组患者的基线特征相似，但封堵组患者年龄更小（47.7±10.8岁 vs 51.9±9.9岁，P = 0.013），且封堵组静息分流更为常见（35.8% vs 10.4%，P = 0.000）。手术成功率为94.0%。在平均27.8个月的随访中，共有6例主要终点事件发生，且均为卒中，仅发生在药物治疗组（6.6% vs 0%，P = 0.039）。封堵组无卒中生存率显著更高（P = 0.026）。结论：我们的研究表明，如果对PFO分流等级为中度以上的选择性患者进行PFO封堵术，可能是预防CS患者复发性卒中和短暂性脑缺血发作的有效治疗策略。
