Percutaneous Patent Foramen Ovale Closure: Stroke and Beyond.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Sandeep Randhawa, Jawahar L Mehta, Gaurav Dhar
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引用次数: 0

Abstract

Over 750,000 individuals suffer from stroke annually in the United States, with 87% of these strokes being ischemic in nature. Roughly 40% of ischemic strokes occur in individuals 60 years of age or under. A quarter of all ischemic strokes have no identifiable cause despite extensive workup and are deemed cryptogenic in nature. Patent Foramen Ovales (PFO) has been postulated in stroke causation by either paradoxical embolization or platelet activation in the tunnel of the defect. The incidence of PFO is reported to be 15-25% in the general population but rises to 40% in patients with cryptogenic stroke. While the initial trials evaluating PFO closures were non-revealing, subsequent long-term follow-ups, as well as recent trials evaluating PFO closures in cryptogenic stroke patients 60 years of age or under, demonstrated the superiority of percutaneous closure compared to medical therapy alone, leading to FDA approval of PFO closure devices. In this review, we review the diagnosis of PFO, postulated stroke mechanisms, literature supporting PFO closure, patient selection for percutaneous closure, procedural considerations, and associated procedural complications.

经皮闭孔器:中风及其他。
美国每年有超过 75 万人罹患中风,其中 87% 为缺血性中风。约 40% 的缺血性中风发生在 60 岁或以下的人群中。在所有缺血性脑卒中中,有四分之一尽管经过大量检查仍无法确定病因,因此被认为是隐源性脑卒中。据推测,卵圆孔未闭(PFO)可通过悖论性栓塞或缺损隧道中的血小板活化导致脑卒中。据报道,PFO 在普通人群中的发病率为 15-25%,而在隐源性中风患者中的发病率则上升至 40%。虽然最初评估 PFO 闭合的试验没有揭示问题,但随后的长期随访以及最近评估 60 岁或以下隐源性卒中患者 PFO 闭合的试验表明,经皮闭合优于单纯药物治疗,因此 FDA 批准了 PFO 闭合装置。在本综述中,我们回顾了 PFO 的诊断、推测的卒中机制、支持 PFO 关闭术的文献、经皮关闭术的患者选择、手术注意事项以及相关的手术并发症。
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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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