J Transcat Intervent.2022;30:eA20210035.
Cross-sectional observational study of patients submitted to percutaneous occlusion of patent foramen ovale: a 20-year retrospective analysis
Edmundo Clarindo Oliveira
, Marcelo Frederigue de Castro
, Marco Antonio Gonçalves de Moura
, Maria Cristina Almeida
, Ana Cristina Lopes Albricker
, Claudia Maria Villas Freire
, José Augusto Almeida Barbosa
DOI: 10.31160/JOTCI202230A20210035
ABSTRACT
Background
Left-to-right shunting via the foramen ovale is a potential cause of paradoxical embolism. The presence of patent foramen ovale in more than 40% of patients with idiopathic ischemic stroke has led to deeper investigation of the impact of its closure on decreasing stroke recurrence rates. This study describes 20 years of experience with percutaneous patent foramen ovale occlusion performed by a single operator.
Methods
This sample comprised 527 patients with ischemic stroke submitted to percutaneous occlusion of patent foramen ovale associated to left-to-right shunting.
Results
The procedure was successful in all cases. The mean age was 48 years (range of 9 to 72 years), and 57% were male. Amplatzer® and Occlutech® prostheses were implanted in 295 and 232 patients (56% and 44%, respectively). There were no deaths, and complications were as follows: hematoma at the puncture site (three patients, 0.6%), femoral arteriovenous fistula with spontaneous resolution (two patients, 0.4%), cardiac tamponade resolved after puncture and drainage (two patients, 0.4%), transient supraventricular arrhythmia (22 patients, 4.2%), headache (27 patients, 5.1%), atrial fibrillation (two patients, 0.4%), large residual shunt requiring a second prosthesis (two patients, 0.4%), recurrence of ischemic stroke within 5 years (four patients, 0.8%) and hypersensitivity to nickel (one patient, 0.2%).
Conclusion
In this series, patent foramen ovale occlusion was a safe and effective alternative for prevention of recurrent ischemic stroke. Recurrence rates over the course of 5 years were low.
Keywords: Atrial fibrillation; Cardiac tamponade; Foramen ovale; Ischemic stroke
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