Farjat-Pasos Julio I, Guedeney Paul, Houde Christine, Alperi Alberto, Mesnier Jules, Côté Melanie, Montalescot Gilles, Rodés-Cabau Josep
Quebec Heart & Lung Institute, Laval University, 2725 Chemin Ste-Foy, G1V 4G5, Quebec City, Quebec, Canada.
J Invasive Cardiol. 2022 Oct;34(10):E720-E725. doi: 10.25270/jic/22.00079. Epub 2022 Sep 23.
Scarce data exist on noncerebrovascular peripheral embolism (NCPE) patients undergoing transcatheter patent foramen ovale (PFO) closure. The objectives of this study were to determine the clinical and procedural characteristics, and long-term outcomes of patients with NCPE undergoing transcatheter PFO closure.
This was a multicenter study including 1136 consecutive patients who underwent PFO closure after a thromboembolic event. Patients were divided into 2 groups according to the type of event leading to PFO closure, ie, cerebrovascular event (CVE, n = 1099 [96.7%]) and NCPE (n = 37 [3.3%]). The median follow-up was 3 years (interquartile range, 1-8), with follow-up complete in 98%.
Patients in the NCPE group exhibited higher rates of prior or concomitant pulmonary embolism (29.7% vs 3.4%; P<.001), and prior myocardial infarction (24.3% vs 1.8%; P<.001). Most NCPE events were located in the limbs (41%), followed by coronary (27%) and renal/splenic/mesenteric arteries (12%). PFO closure was successful in all patients, with a low complication rate (<1%) in both groups. NCPE patients were more frequently treated with anticoagulation following PFO closure (63% vs 13%; P<.001). There were no differences between NCPE and CVE groups in death (0 per 100 patient years vs 0.4 per 100 patient-years; P=.53) or cerebrovascular events (1.3 per 100 patient-years vs 0.4 per 100 patient-years; P=.15) at follow-up.
Patients with NCPE events undergoing PFO closure exhibited differential baseline characteristics compared with patients with CVEs; limbs and coronary arteries were the most frequent NCPE location. PFO closure results and long-term outcomes were similar to their CVE counterparts, with a very low rate of recurrent thromboembolic events. Further studies are needed in this population.
关于接受经导管卵圆孔未闭（PFO）封堵术的非脑血管性外周栓塞（NCPE）患者的数据稀缺。本研究的目的是确定接受经导管PFO封堵术的NCPE患者的临床和手术特征以及长期预后。
这是一项多中心研究，纳入了1136例在血栓栓塞事件后接受PFO封堵术的连续患者。根据导致PFO封堵的事件类型，将患者分为两组，即脑血管事件（CVE，n = 1099 [96.7%]）和NCPE（n = 37 [3.3%]）。中位随访时间为3年（四分位间距，1 - 8年），98%的患者完成随访。
NCPE组患者既往或合并肺栓塞的发生率更高（29.7%对3.4%；P<0.001），既往心肌梗死的发生率也更高（24.3%对1.8%；P<0.001）。大多数NCPE事件位于四肢（41%），其次是冠状动脉（27%）和肾/脾/肠系膜动脉（12%）。所有患者的PFO封堵均成功，两组的并发症发生率均较低（<1%）。NCPE患者在PFO封堵术后接受抗凝治疗的频率更高（63%对13%；P<0.001）。随访时，NCPE组和CVE组在死亡（每100患者年0例对每100患者年0.4例；P = 0.53）或脑血管事件（每100患者年1.3例对每100患者年0.4例；P = 0.15）方面无差异。
与CVE患者相比，接受PFO封堵术的NCPE患者表现出不同的基线特征；四肢和冠状动脉是最常见的NCPE发生部位。PFO封堵结果和长期预后与CVE患者相似，复发性血栓栓塞事件发生率极低。该人群需要进一步研究。
