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圈套器取出卵圆孔未闭封堵器栓塞:1 例报告。

Snare device retrieval of occluder embolized in patent foramen ovale closure: A case report.

机构信息

Department of Cardiovascular Medicine, Dezhou Hospital, Qilu Hospital of Shandong University, Dezhou, China.

出版信息

Medicine (Baltimore). 2024 May 31;103(22):e38299. doi: 10.1097/MD.0000000000038299.

DOI:10.1097/MD.0000000000038299
PMID:39259122
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11142812/
Abstract

RATIONALE

Transcatheter interventional closure therapy is the main treatment method for patent foramen ovale (PFO). However, occluder abscission is a serious complication in PFO interventional therapy. Thus, timely and effective management of the occluder detachment is crucial for improving patient prognosis.

PATIENT CONCERNS

A 52-year-old female patient was admitted to the Department of Neurology mainly due to "right upper limb weakness for two days, which aggravated for eight hours." The patient had no history of any other diseases.

DIAGNOSES

The patient was diagnosed with an atrial septal defect (foramen ovale type) and cerebral infarction.

INTERVENTIONS AND OUTCOMES

The occluder abscission was successfully removed after several attempts with the help of the snare device.

LESSONS

When the PFO occlusion device is detached, interventional treatment would lead to minimal trauma, fast postoperative recovery, and a definite therapeutic effect. Based on mastering the indications and standardizing the operational process, this is a safe and effective minimally invasive treatment method.

摘要

理由

卵圆孔未闭(PFO)的主要治疗方法是经导管介入封堵治疗。然而,封堵器脱落是 PFO 介入治疗的严重并发症。因此,及时有效地处理封堵器脱落对于改善患者预后至关重要。

患者关注

一名 52 岁女性患者因“右侧上肢无力 2 天,加重 8 小时”就诊于神经内科。患者无其他病史。

诊断

患者被诊断为房间隔缺损(卵圆孔型)和脑梗死。

干预措施及结果

在圈套器的帮助下,经过多次尝试,成功取出了脱落的封堵器。

教训

当 PFO 封堵器脱落时,介入治疗创伤极小,术后恢复快,治疗效果确切。在掌握适应证和规范操作流程的基础上,这是一种安全有效的微创治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec0a/11142812/478494ef3383/medi-103-e38299-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec0a/11142812/478494ef3383/medi-103-e38299-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec0a/11142812/478494ef3383/medi-103-e38299-g001.jpg

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Snare device retrieval of occluder embolized in patent foramen ovale closure: A case report.圈套器取出卵圆孔未闭封堵器栓塞:1 例报告。
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本文引用的文献

1
Post-Market Clinical Follow-Up With the Patent Foramen Ovale Closure Device IrisFIT (Lifetech) in Patients With Stroke, Transient Ischemic Attack, or Other Thromboembolic Events.采用 Lifetech 公司的 IrisFIT 卵圆孔未闭封堵器进行上市后临床随访:用于治疗卒中和短暂性脑缺血发作或其他血栓栓塞性事件的患者。
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Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke.关于卵圆孔未闭相关性卒中潜在病因机制命名和分类更新的建议。
JAMA Neurol. 2020 Jul 1;77(7):878-886. doi: 10.1001/jamaneurol.2020.0458.
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Cryptogenic Stroke and High-Risk Patent Foramen Ovale: The DEFENSE-PFO Trial.
隐源性卒中与高风险卵圆孔未闭:DEFENSE-PFO 试验。
J Am Coll Cardiol. 2018 May 22;71(20):2335-2342. doi: 10.1016/j.jacc.2018.02.046. Epub 2018 Mar 12.
4
Cryptogenic Stroke and Patent Foramen Ovale.隐源性卒中与卵圆孔未闭。
J Am Coll Cardiol. 2018 Mar 6;71(9):1035-1043. doi: 10.1016/j.jacc.2017.12.059.
5
Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke.卵圆孔未闭封堵或卒中后药物治疗的长期结局。
N Engl J Med. 2017 Sep 14;377(11):1022-1032. doi: 10.1056/NEJMoa1610057.
6
Atrial septal defect occluder dislocation engaged through the tricuspid valve: surgical removal via right thoracotomy.房间隔缺损封堵器经三尖瓣脱位嵌顿:经右胸切口手术取出
Kardiol Pol. 2017;75(3):279. doi: 10.5603/KP.2017.0052.
7
PFO and Migraine: Is There a Role for Closure?房间隔缺损与偏头痛:封堵术是否有效?
Curr Neurol Neurosci Rep. 2017 Mar;17(3):20. doi: 10.1007/s11910-017-0730-5.
8
Short and long term complications of device closure of atrial septal defect and patent foramen ovale: meta-analysis of 28,142 patients from 203 studies.经导管房间隔缺损和卵圆孔未闭封堵器械治疗的近期和远期并发症:203 项研究 28142 例患者的荟萃分析。
Catheter Cardiovasc Interv. 2013 Dec 1;82(7):1123-38. doi: 10.1002/ccd.24875. Epub 2013 Aug 31.
9
Transcatheter retrieval of embolized AMPLATZER Septal Occluder.经导管取出栓塞的Amplatzer房间隔封堵器。
Tex Heart Inst J. 2012;39(5):653-6.
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Patent foramen ovale: current pathology, pathophysiology, and clinical status.卵圆孔未闭:当前的病理学、病理生理学及临床状况
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