1. Recurrent cerebral ischemia after patent foramen ovale percutaneous closure in older patients: A two-center registry study.
- Author
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Scacciatella P, Meynet I, Presbitero P, Giorgi M, Lucarelli C, Zavalloni Parenti D, Biava LM, and Marra S
- Subjects
- Age Factors, Aged, Brain Ischemia diagnostic imaging, Chi-Square Distribution, Disease-Free Survival, Female, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnostic imaging, Humans, Italy, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Multivariate Analysis, Recurrence, Registries, Risk Factors, Time Factors, Treatment Outcome, Brain Ischemia etiology, Cardiac Catheterization adverse effects, Foramen Ovale, Patent therapy
- Abstract
Objectives: The aim of this study is to describe the cerebral ischemia recurrence rate after percutaneous patent foramen ovale (PFO) closure in patients older than 55 years and their outcomes, compared with younger patients., Background: The registries data and the recent randomized trials about PFO closure are focused on patients younger than 55 years. Little is known about older patients' long-term outcome., Methods: In total, 458 patients underwent PFO closure for cryptogenic cerebral ischemia and were stratified into an "older" (≥ 55 years, 151 patients) and a "younger" (<55 years, 307 patients) group., Results: Older patients had mean age of 63 ± 6 years and more atrial septum aneurysm (P = 0.05), hypertension, diabetes, and dyslipidemia (P = 0.001). Mean followup was 4.5 ± 2.8 years. Older patients had a higher rate of ischemic recurrence (0.3 vs. 4.0%, P = 0.002), after a mean time of 3.1 ± 2.6 years. The Kaplan-Meier curve confirmed higher event-free survival in the youngers (P = 0.008). None of the patients with ischemic recurrence had significant residual shunt. Age and hypertension were correlated to ischemic recurrence, but age was the only independent predictor at multivariate analysis., Conclusions: Recurrent cerebral ischemia after PFO closure is more frequent in older patients and could most likely be associated to conditions related to age (atherosclerosis, atrial fibrillation), than to paradoxical embolism. The procedure is as safe as in younger patients., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2016
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