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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Percutaneous closure of patent foramen ovale (PFO) has been proposed as the treatment of choice for young high-risk patients who suffered cryptogenic stroke and/or peripheral paradoxical embolism. We sought to compare prospectively two different devices used for percutaneous PFO closure.Prospective data were collected on 40 high risk patients (females: 38%, mean age : 44 +/- 11 years, interatrial septal aneurysm >10 mm: 68%) who underwent percutaneous PFO closure after cryptogenic stroke (n = 38) or peripheral paradoxical embolism (n = 2). Chronologically, 20 patients were first treated by a PFO-Star (Cardia, Burnsville, MI) device. Then, 20 other patients received a Starflex occluder (NMT, Boston, MA). The primary endpoint was complete PFO closure at 6 months as assessed by transthoracic contrast echocardiography. Secondary endpoints were major peri- or post procedural complications and clinical recurrence at 1 year follow-up.Baseline clinical and anatomical characteristics were comparable for both groups. Complete PFO closure was observed in 50% (PFO-Star) and 90% (Starflex) of patients (p=0.001) respectively. Major peri-procedural complications occurred in the PFO-star group only: right-sided device thrombus (1 patient) and aorto-right atrial fistula (1 patient). At 1 year follow-up, no clinical recurrence occurred.In conclusion, despite the absence of clinical recurrence in this high-risk population with presumed paradoxical embolism, complete PFO closure at 6 months follow-up was significantly related to the type of closure device used.
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PMID:Percutaneous closure of patent foramen ovale: head-to-head comparison of two different devices. 1975 76

Patients with compelling evidence of cryptogenic stroke due to patent foreamen ovale (PFO) are increasingly likely to be offered percutaneous closure of the defect. With improvements in technique there is now a high procedural success rate with low rates of periprocedural complications. Late complications are also rare, but include late perforation of the aortic root, which is rapidly progressive and potentially fatal. This has lead to the development of lower profile devices, which aim to reduce the risk of both early and late complications. At this stage, it is not clear if lower profile devices have safety profiles which are superior to the more established devices. We report the first case of late perforation of the aortic sinus by the lower profile Atriasept (Cardia) device presenting as life threatening cardiac tamponade in an adult who previously underwent percutaneous PFO closure.
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PMID:Late aortic perforation with an Atriasept device resulting in life-threatening tamponade. 2057 19