Clinical and Brain Magnetic Resonance Imaging Follow-up After Percutaneous Closure of Patent Foramen Ovale in Patients With Cryptogenic Stroke

Carlo Vigna, Vincenzo Inchingolo, Giuseppe Giannatempo, Michele A. Pacilli, Pietro Di Viesti, Saverio Fusilli, Cesare M. Amico, Tiberio Santoro, Pompeo Lanna, Raffaele Fanelli, Pasquale Simone, Francesco Loperfido

Research output: Contribution to journalArticle

Abstract

Patent foramen ovale (PFO) closure is reported to result in fewer episodes of clinically manifest recurrent cerebral ischemia than medical treatment. We evaluated by means of magnetic resonance imaging (MRI) whether silent cerebral ischemic episodes are also decreased by PFO closure. Seventy-one patients with PFO were selected for percutaneous closure of PFO at our center. All had PFO with large right-to-left shunt documented by transcranial Doppler ultrasound and transesophageal echocardiography, ≥1 previous stroke or transient ischemic attack with MRI documentation at the index event, and no alternative cause for cerebral ischemia. MRI studies were performed in all patients 24 hours before the procedure and at 1-year follow-up (or before in the case of a suspected new neurologic event). Eight patients (11%) had >1 clinical event before the procedure. Comparing the 2 MRI studies before the procedure, silent ischemic lesions were observed in 14 other patients (20%). Thus, considering clinical and silent events together, >1 event was present at baseline in 22 patients (31%). After PFO closure (follow-up 16 ± 7 months), 1 recurrent neurologic event occurred (1%, p = 0.02 vs preprocedural clinical events); however, urgent brain MRI results were negative. Moreover, only 1 patient showed 1 new silent lesion at brain MRI at follow-up (1%, p

Original languageEnglish
Pages (from-to)1051-1055
Number of pages5
JournalThe American Journal of Cardiology
Volume101
Issue number7
DOIs
Publication statusPublished - Apr 1 2008

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Vigna, C., Inchingolo, V., Giannatempo, G., Pacilli, M. A., Di Viesti, P., Fusilli, S., Amico, C. M., Santoro, T., Lanna, P., Fanelli, R., Simone, P., & Loperfido, F. (2008). Clinical and Brain Magnetic Resonance Imaging Follow-up After Percutaneous Closure of Patent Foramen Ovale in Patients With Cryptogenic Stroke. The American Journal of Cardiology, 101(7), 1051-1055. https://doi.org/10.1016/j.amjcard.2007.11.050