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日本真实世界卵圆孔未闭(PFO)封堵术 - Amplatzer PFO 封堵器日本上市后监测研究的 30 天临床结局。

Real-World Patent Foramen Ovale (PFO) Closure in Japan - 30-Day Clinical Outcomes From the Amplatzer PFO Occluder Japan Post-Marketing Surveillance Study.

机构信息

Department of Cardiovascular Medicine, Okayama University Hospital.

Division of Cardiovascular Medicine, Toho University Ohashi Medical Center.

出版信息

Circ J. 2024 Aug 23;88(9):1391-1397. doi: 10.1253/circj.CJ-24-0080. Epub 2024 May 11.

Abstract

BACKGROUND

The Amplatzer PFO Occluder was approved for marketing in Japan in May 2019, and the Amplatzer PFO Occluder Japan Post-marketing Surveillance (PFO Japan PMS) study was initiated in December 2019. This analysis presents 30-day clinical outcomes for PFO Japan PMS study patients.

METHODS AND RESULTS

PFO Japan PMS is a prospective single-arm non-randomized multicenter clinical study. Eligible patients were indicated for patent foramen ovale (PFO) closure and underwent an implant attempt with the Amplatzer PFO Occluder. Technical success was defined as successful delivery and release of the occluder; procedural success was defined as technical success with no serious adverse events (SAEs) within 1 day of the procedure. The primary safety endpoint includes predefined device- and/or procedure-related SAEs through 30 days after the procedure. From December 2019 to July 2021, 500 patients were enrolled across 53 Japanese sites. The mean (±SD) patient age was 52.7±15.4 years, and 29.8% of patients were aged >60 years. Technical and procedural success rates were both high (99.8% and 98.8%, respectively). Further, there was only one primary safety endpoint event (0.2%): an episode of asymptomatic paroxysmal atrial fibrillation that occurred 26 days after the procedure.

CONCLUSIONS

In this real-world Japanese study with almost one-third of patients aged >60 years, PFO closure with the Amplatzer PFO Occluder was performed successfully and safely, with a low incidence of procedure-related atrial arrhythmias.

摘要

背景

Amplatzer PFO 封堵器于 2019 年 5 月在日本获得上市批准,随后启动了 Amplatzer PFO 封堵器日本上市后监测(PFO Japan PMS)研究。本分析报告介绍了 PFO Japan PMS 研究患者的 30 天临床结局。

方法和结果

PFO Japan PMS 是一项前瞻性、单臂、非随机、多中心临床研究。符合条件的患者存在卵圆孔未闭(PFO),并尝试使用 Amplatzer PFO 封堵器进行植入。技术成功定义为封堵器成功输送和释放;程序成功定义为技术成功且术后 1 天内无严重不良事件(SAE)。主要安全性终点包括术后 30 天内与器械和/或程序相关的预先定义的 SAE。从 2019 年 12 月至 2021 年 7 月,53 个日本中心共入组了 500 例患者。患者平均(±SD)年龄为 52.7±15.4 岁,29.8%的患者年龄>60 岁。技术和程序成功率均很高(分别为 99.8%和 98.8%)。此外,仅发生了 1 例主要安全性终点事件(0.2%):术后 26 天发生无症状阵发性心房颤动。

结论

在这项涉及近三分之一患者年龄>60 岁的日本真实世界研究中,使用 Amplatzer PFO 封堵器进行 PFO 封堵安全有效,与程序相关的房性心律失常发生率低。

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