Fu Q, Guo C X, Du L J, Bai Y Q, Gong X P, Ju Y, Lu J J, Hu J K, Qu H, Dong K H, Chen B X, Wang Y J
Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Nov 24;46(11):882-886. doi: 10.3760/cma.j.issn.0253-3758.2018.11.012.
To investigate the efficacy and outcome of transcatheter patent foramen ovale (PFO) closure in patients with cryptogenic stroke (CS). Sixty consecutive patients with cryptogenic stroke who undertook transcatheter PFO closure between May 2015 and September 2017 in Beijing Tiantan Hospital were enrolled in this prospective study.Transcranial Doppler (TCD) bubble test was performed and right-left shunt(RLS) was confirmed in all patients.Closure success rate,effective closure rate, complications, recurrence of ischemic stroke and new onset atrial fibrillation were evaluated. A total of 60 patients (42 male,age range 24-68 (47±11)years) were included in the study.PFO size (motionless state) was (1.6±0.6)mm.RLS before closure was graded and 11 patients had moderate RLS and 48 patients had large RLS (include 41 patients who experienced shower or curtain effect).Closure success rate was 100% (60/60).No severe complications were observed.At 6 months,45 patients completed TCD bubble test.Of these, 4 patients suffered from moderate to large residual and thus effective closure rate was 91%(41/45).The mean follow-up period was 2-29 (median 12) months. During the follow-up, only 1 patient experienced recurrent cerebral infarction.New onset atrial fibrillation was not detected. Transcatheter PFO closure is effective,safe and related with a good outcome in reduction of recurrent CS for patients with PFO.
探讨经导管封堵卵圆孔未闭（PFO）治疗隐源性卒中（CS）患者的疗效及预后。连续纳入2015年5月至2017年9月在北京天坛医院接受经导管PFO封堵术的60例隐源性卒中患者进行这项前瞻性研究。所有患者均行经颅多普勒（TCD）气泡试验，证实存在右向左分流（RLS）。评估封堵成功率、有效封堵率、并发症、缺血性卒中复发及新发房颤情况。本研究共纳入60例患者（男性42例，年龄24 - 68岁（47±11岁））。PFO大小（静止状态）为（1.6±0.6）mm。封堵前对RLS进行分级，11例患者为中度RLS，48例患者为大量RLS（包括41例出现雨帘效应的患者）。封堵成功率为100%（60/60）。未观察到严重并发症。6个月时，45例患者完成TCD气泡试验。其中，4例患者存在中度至大量残余分流，因此有效封堵率为91%（41/45）。平均随访时间为2 - 29个月（中位数12个月）。随访期间，仅1例患者发生复发性脑梗死。未检测到新发房颤。经导管PFO封堵术对于PFO患者减少复发性CS有效、安全且预后良好。
