Shortened dual anti-platelet therapy duration after percutaneous patent foramen ovale and atrial septal defect closure.

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Invasive Cardiology Pub Date : 2025-08-11 DOI:10.25270/jic/25.00118

Ankur Srivastava, Dhruvil A Patel, AbdulRahman Dia, Sandeep Nathan, John E Blair, Jonathan Paul, Prateek Sharma, Jennifer Smazil, Lauren Roark, Janet Friant, Moira McDowell, Rohan Kalathiya, Atman P Shah

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引用次数: 0

Abstract

Objectives: Current guidelines recommend patent foramen ovale (PFO) closure in patients with cryptogenic stroke, while atrial septal defect (ASD) closure is indicated for a shunt with right atrial/right ventricular (RV) enlargement. Major procedural complication rates from PFO/ASD closure are low. However, there is a theoretical risk of thrombus formation early after implantation, prior to endothelialization of the device, that may be prevented by dual antiplatelet therapy (DAPT). There is little data on the optimal timing and duration of DAPT post-device placement; thus, this study aimed to evaluate the safety of shortened DAPT after PFO/ASD closure with respect to device thrombosis and clinical stroke.

Methods: One hundred ninety-four patients 18 years or older who underwent transcatheter PFO/ASD closure from 2010 to 2021 were included in the study. The primary outcome was the rate of device thrombosis at 1 year. The secondary outcome was stroke and peripheral embolization at 1 year.

Results: Closures were primarily performed for cryptogenic stroke (41.9%) and ASD closure for RV enlargement (26.9%). The average length of DAPT was 2.91 ± 2.6 months. At 1 year, there were no cases of device thrombosis or embolization.

Conclusions: This study suggests that 3 months or less of DAPT may be safe in patients after percutaneous PFO/ASD closure.

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缩短经皮卵圆孔未闭和房间隔缺损闭合术后双重抗血小板治疗时间。

目的：目前的指南推荐隐源性卒中患者闭合卵圆孔未闭（PFO），而房间隔缺损（ASD）闭合适用于右房/右心室（RV）扩大的分流术。PFO/ASD闭合的主要手术并发症发生率较低。然而，在植入后早期，在设备内皮化之前，理论上存在血栓形成的风险，这可以通过双重抗血小板治疗（DAPT）来预防。关于DAPT植入后的最佳时间和持续时间的数据很少；因此，本研究旨在评估PFO/ASD关闭后缩短DAPT在装置血栓形成和临床卒中方面的安全性。方法：2010年至2021年，194例18岁及以上的经导管PFO/ASD闭合患者纳入研究。主要观察指标为1年器械血栓发生率。次要结果是1年时中风和外周栓塞。结果：隐源性卒中主要采用闭合术（41.9%），RV增大主要采用ASD闭合术（26.9%）。DAPT的平均时间为2.91±2.6个月。1年无器械血栓形成或栓塞病例。结论：本研究表明，经皮PFO/ASD闭合后患者接受3个月或更短时间的DAPT治疗可能是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Invasive Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.90

自引率

6.70%

发文量

214

审稿时长

3-8 weeks

期刊介绍： The Journal of Invasive Cardiology will consider for publication suitable articles on topics pertaining to the invasive treatment of patients with cardiovascular disease.