Abstract Closure of patent foramen ovale (PFO) is non-inferior to medical treatment for patients with cryptogenic stroke. Results in randomised trials might be based on the different types of used occluders. We determined residual shunting with serial contrast transoesophageal echocardiography (cTEE) and evaluated rates of recurrent cerebrovascular events in a long-term follow-up. cTEE was repeated three and 12 months after PFO closure using AMPLATZER (n=109), BioSTAR (n=68), Cardia (n=104) or P...
Abstract Objectives To retrospectively evaluate the impact on daily activities of transcatheter closure of patent foramen ovale (PFO) versus medical therapy in patients with migraine and to analyze the role of the residual shunt after PFO closure. Background While non-controlled observational studies reported an improvement of migraine after PFO closure, a randomized trial has shown no benefit of such an intervention. The role of residual shunt after PFO closure is also poorly known. Methods Out...
Abstract Background Patent foramen ovale (PFO) might be a risk factor for unexplained ("cryptogenic") stroke or transient ischemic attack (TIA). We sought to determine the efficacy and safety of transcatheter PFO closure compared with antithrombotic therapy for secondary prevention of cerebrovascular events among patients with cryptogenic stroke. Methods We performed a systematic review and meta-analysis of MedLine and Embase (from inception to March 2013) for randomized controlled trials (RCTs)...
BACKGROUND: Paradoxical embolization through a right-to-left shunt (RLS), often from a patent foramen ovale (PFO), has been associated with cryptogenic stroke. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo (TTE) remains the most commonly used screening test for RLS due to its noninvasiveness and easy availability. The aim of this meta-analysis was to determine the accuracy of TTE compared to TEE as the reference. METHODS AN...
Of cryptogenic stroke patients younger than 55 years of age, up to 61% have had a patent foramen ovale (PFO). Observational studies have revealed reductions in recurrent neurologic events through PFO closure versus medical therapy, and randomized controlled trials have shown nonsignificant trends toward benefit. We systematically searched for randomized controlled trials of percutaneous PFO closure with medical therapy versus medical therapy alone in patients with cryptogenic stroke and performe...
#2Jared S. Winoker(Albert Einstein College of Medicine)H-Index: 7
Last. Ronald Zolty(Albert Einstein College of Medicine)H-Index: 19
view all 6 authors...
Right-to-left shunting (RLS), usually through a patent foramen ovale (PFO), has been associated with migraine, cryptogenic stroke and hypoxemia. With emerging observational studies and clinical trials on the subject of PFO, there is a need for accurate diagnosis of PFO in patients being considered for transcatheter closure. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo with second harmonic imaging (TTE-HI) may be a preferab...
Objective To review efficacy of percutaneous closure of patent foramen ovale compared with medical therapy in prevention of recurrent strokes in patients with cryptogenic stroke. Methods and Results Electronic databases; PUBMED, EMBASE, Cochrane registry and web of knowledge were searched for relevant studies. In three randomised clinical trials involving 2303 participants, risk of the recurrent strokes (pooled HR 0.62, 95% CI=0.36-1.07, P=0.09, I 2 =10%) did not show benefit with device closure...
AIMS: We aimed at updating the evidence coming from randomised and observational studies of patent foramen ovale (PFO) closure compared to medical therapy in patients with cryptogenic stroke (CS). METHODS AND RESULTS: Comparative studies of PFO closure versus medical therapy published or presented through March 2013 were identified. Data from 2,303 patients in three randomised clinical trials (RCTs) and from 2,231 patients in 11 observational studies were included. In RCTs, the stroke hazard rat...
Objectives To provide a comprehensive comparison of patent foramen ovale (PFO) closure versus medical therapy in patients with cryptogenic stroke or transient ischaemic attack (TIA) and demonstrated PFO. Design Systematic review with complete case meta-analysis and sensitivity analyses. Data sources included MEDLINE and EMBASE from 1980 up to May 2013. All randomised controlled trials (RCTs) comparing treatment with percutaneous catheter-based closure of PFO to anticoagulant or antiplatelet ther...
#2Vincent Thijs(Florey Institute of Neuroscience and Mental Health)H-Index: 77
Background and Purpose: Multiple studies evaluated whether patent foramen ovale (PFO) closure reduces the risk of ischemic stroke. One commonly reported complication of PFO closure is the developme...
Patent foramen ovale (PFO) and cryptogenic stroke (CS) both have a high prevalence. The optimal treatment to reduce stroke recurrence after CS remains controversial. Results from clinical trials, meta-analyses, and position papers, support percutaneous PFO device closure and medical therapy compared to medical therapy alone. However, the procedure may be associated with cardiac complications including an increased incidence of new atrial fibrillation. The benefit/risk balance should be determine...
RATIONALE: Patent foramen ovale (PFO) is not considered to be the main cause of stroke and is classified as the infarction of undetermined cause. The relationship between PFO and cerebral embolism is still unclear and cerebral embolism accompanied with coronary artery embolization in PFO patient is rare. In this case, we reported a patient with PFO suffered acute cerebral and myocardial infarction simultaneously, and analyzed the source of emboli and potential pathogenesis. PATIENT CONCERNS: A 5...
Abstract Introduction and objectives Randomized trials have shown the efficacy of transcatheter closure of patent foramen ovale (PFO) in patients aged ≤ 60 years with cryptogenic embolism. We aimed to assess the long-term safety and efficacy of PFO closure in patients aged > 60 years. Methods Of 475 consecutive patients with cryptogenic embolism who underwent PFO closure, 90 older patients aged > 60 years (mean, 66 ± 5 years) were compared with 385 younger patients aged ≤ 60 years (mean, 44 ± 10...
Resumen Introduccion y objetivos Estudios aleatorizados han mostrado la eficacia del cierre percutaneo del foramen oval permeable (FOP) en pacientes de edad ≤ 60 anos con ictus criptogenico. El objetivo de este estudio es determinar la seguridad y la eficacia a largo plazo del cierre percutaneo del FOP en pacientes mayores de 60 anos con ictus criptogenico. Metodos De 475 pacientes consecutivos con ictus criptogenico que se sometieron al cierre del FOP, 90 eran mayores de 60 anos (media, 66 ± 5 ...
Abstract Background Patent foramen ovale (PFO) closure is the gold standard for treating patients with cryptogenic stroke and PFO. However, scarce data exist on the long-term outcomes following PFO closure. Objectives The purpose of this study was to determine the long-term (>10 years) clinical outcomes (death, ischemic, hemorrhagic events) following transcatheter PFO closure. Methods We included 201 consecutive patients (mean age: 47 ± 12 years, 51% women) who underwent PFO closure due to a cry...
Abstract Device embolization is a rare complication of transcatheter structural heart interventions. Although the majority of device embolizations can be treated in a semielective manner, some are life threatening and require prompt intervention. Awareness of this potential complication, and knowledge of retrieval tools and techniques are essential to the structural interventionalist. This paper offers a succinct review of the incidence, and outcomes of device embolization during common structur...
: Stroke is the second leading cause of death globally and can lead to significant adverse outcomes in patients following the acute illness. Due to this high morbidity and mortality, adequate interventions can play a significant role in health outcomes. Patent foramen ovale is one of the major proposed causes of cryptogenic strokes and can be present in up to 25% of general population. In cryptogenic strokes, the relation of this structural heart defect is inversely proportional to age of patien...
Last. Jinlan Wu(SZU: Shenzhen University)H-Index: 1
view all 8 authors...
Abstract Background The efficacy of patent foramen ovale (PFO) closure for secondary stroke prevention in cryptogenic stroke (CS) patients with PFO is uncertain. This meta-analysis aims to assess whether PFO closure is superior to medical therapy. Methods Pooled estimates were calculated using Revman 5.3. The two primary endpoints were stroke and transient ischemic attack (TIA). Secondary outcomes included all-cause mortality, new-onset atrial fibrillation or flutter, major bleeding and any adve...
The optimal management of patients with cryptogenic stroke (CS) and patent foramen ovale (PFO) remains controversial. We conducted a meta-analysis to assess the effect of PFO closure for secondary prevention of stroke on patients with CS. We searched the literature for randomized control trials assessing the recurrence of stroke after PFO closure compared with medical therapy (antiplatelet and/or anticoagulation). Five randomized control trials with a total of 3,440 patients were included. The m...