Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Department of Neurology, Suzhou Ninth People's Hospital, 215200, China.
Biomed Res Int. 2022 Jan 30;2022:2614225. doi: 10.1155/2022/2614225. eCollection 2022.
Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS). Transcatheter closure of PFO is superior to pharmacotherapy for patients with CS or transient ischemic attack (TIA). More evidence is needed to evaluate the efficacy and safety of PFO closure in Chinese patients.
This study enrolled ten CS patients and two TIA patients (mean age of 40.8 ± 9.7 y), including seven males (58%) and five females (42%) who underwent PFO closure in our center from January 2017 to July 2019. Baseline data, imaging data, and RoPE (Risk of Paradoxical Embolism) score were collected retrospectively. The preprocedural assessment and percutaneous transcatheter PFO closure were described in detail. The perioperative complications and follow-ups were recorded from all patients.
Among ten patients with CS, eight patients had a RoPE score of >6 and two patients had a RoPE score of 6. MRI confirmed multiple infarcts in seven cases, and infarct involving the cortex in nine cases. Abnormal ECG was found in three patients and abnormal Echo in four patients. Right-to-left shunt (RLS) was detected in all the patients by cTCD or cTTE. To be specific, RLS was observed in nine of the ten TEE-detected patients. No case had PFO complicated with atrial septal aneurysm (ASA). The success rate of PFO closure was 91.6%. No serious perioperative complications were observed. During a mean time of 26.5 ± 8 months (15-41 months) of follow-up, no recurrent cerebral infarction, TIA, or thromboembolism were detected in postoperative patients.
PFO closure is safe and effective in the treatment of Chinese patients with CS or TIA.
卵圆孔未闭（PFO）与隐源性卒中（CS）有关。对于 CS 或短暂性脑缺血发作（TIA）患者，经导管 PFO 封堵优于药物治疗。需要更多的证据来评估 PFO 封堵在我国患者中的疗效和安全性。
本研究纳入了 2017 年 1 月至 2019 年 7 月在我院接受 PFO 封堵的 10 例 CS 患者和 2 例 TIA 患者（平均年龄 40.8±9.7 岁；男性 7 例[58%]，女性 5 例[42%]）。回顾性收集了基线数据、影像学数据和 RoPE（反常栓塞风险）评分。详细描述了术前评估和经皮经导管 PFO 封堵。记录了所有患者的围手术期并发症和随访情况。
10 例 CS 患者中，8 例 RoPE 评分>6 分，2 例 RoPE 评分 6 分。MRI 证实 7 例存在多发梗死，9 例梗死累及皮质。3 例患者心电图异常，4 例患者超声心动图异常。所有患者均通过 cTCD 或 cTTE 检测到右向左分流（RLS）。具体来说，10 例 TEE 检测到的患者中，有 9 例存在 RLS。无 PFO 合并房间隔瘤（ASA）病例。PFO 封堵成功率为 91.6%。无严重围手术期并发症发生。在平均 26.5±8 个月（15-41 个月）的随访期间，术后患者均未出现复发性脑梗死、TIA 或血栓栓塞。
PFO 封堵治疗我国 CS 或 TIA 患者安全有效。
