Safety and efficacy of endovascular patent foramen ovale closure: the first results of a Russian multicenter study
https://doi.org/10.14412/2074-2711-2020-6-26-32
Abstract
Patent foramen ovale (PFO) is detectable in more than 25% of the adult population and is generally clinically insignificant. However, it can be a cause of paradoxical embolism in some cases. Randomized trials indicate that endovascular PFO closure in patients with a history of cryptogenic stroke is an effective method for the secondary prevention of catastrophic brain damage.
Objective: to study the safety and efficiency of endovascular PFO closure in young patients with a history of cryptogenic stroke.
Patients and methods. Sixty-two patients, including (22 males and 40 females) women, underwent percutaneous PFO closure in May 2018 to March 2020. The patients' mean age was 37.4±7.6 years. The inclusion criteria were a prior cryptogenic ischemic stroke lasting less than 12 months and PFO with a high risk for paradoxical embolism (PFO concurrent with atrial septal aneurysm or hypermobility; PFO, ≥2 mm size; the presence of the Chiari network and/or the Eustachian valve).
Results and discussion. The technical success of the operation was achieved in all cases. In 50 (80.6%) patients, the right chamber of the heart was completely isolated from the left one in the first 3 months. During the first year, the atria were also completely isolated in 10 (16.1%) patients. A left-to-right shunt persisted in 2 (3.2%) patents 12 months later. Two patients were found to have main procedural complications: one had perioperative atrial fibrillation and the other had pseudoaneurysm formation at the puncture site.
Conclusion. Endovascular PFO closure is a safe and effective operation for the secondary prevention of recurrent ischemic stroke. In our study, blood shunting through the PFO was stopped in 96.6% of patients at less than 6 months after surgery, which suggests that there is a rapid and effective reduction in the risk of paradoxical embolism.
About the Authors
D. V. OgnerubovRussian Federation
Dmitry Viktorovich Ognerubov
15a, Third Cherepkovskaya St., Moscow 121552
A. S. Tereshchenko
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
A. N. Samko
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
G. К. Arutyunyan
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
O. A. Sivakova
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
D. V. Pevzner
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
M. I. Makeev
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
T. V. Balakhonova
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
A. V. Belopasova
Russian Federation
80, Volokolamskoe Shosse, Moscow 125367
M. Yu. Maksimova
Russian Federation
80, Volokolamskoe Shosse, Moscow 125367
S. E. Chuprina
Russian Federation
151, Moskovsky Prospect, Voronezh 394066
E. P. Khodyakova
Russian Federation
151, Moskovsky Prospect, Voronezh 394066
A. A. Kulesh
Russian Federation
26, Petropavlovskaya St., Perm 614990
S. A. Mekhryakov
Russian Federation
2, KIM St., Perm 614107
D. Yu. Shchekochikhin
Russian Federation
8, Leninsky Prospect, Moscow 119049,
8, Trubetskaya St., Build. 2, Moscow 119991
A. A. Bogdanova
Russian Federation
8, Leninsky Prospect, Moscow 119049,
1, Ostrovityanov St., Moscow 117997
E. V. Merkulov
Russian Federation
15a, Third Cherepkovskaya St., Moscow 121552
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Review
For citations:
Ognerubov DV, Tereshchenko AS, Samko AN, Arutyunyan GК, Sivakova OA, Pevzner DV, Makeev MI, Balakhonova TV, Belopasova AV, Maksimova MY, Chuprina SE, Khodyakova EP, Kulesh AA, Mekhryakov SA, Shchekochikhin DY, Bogdanova AA, Merkulov EV. Safety and efficacy of endovascular patent foramen ovale closure: the first results of a Russian multicenter study. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(6):26-32. (In Russ.) https://doi.org/10.14412/2074-2711-2020-6-26-32