title: Percutaneous closure of patent foramen ovale in patients with presumed paradoxical embolism: periprocedural results and midterm risk of recurrent neurologic events.
abstract: OBJECTIVE
  To report our data on selected patients with previous paradoxical embolism who underwent transcatheter patent foramen ovale (PFO) closure.
  
  
  METHODS
  Between July 2001 and July 2007, percutaneous PFO closure was performed on 128 patients (65 women, mean age: 46 +/- 12.8 years). Patent foramen ovale closure was recommended for secondary prevention in patients with previous transient ischemic attacks (52.5%), stroke (46%), or peripheral embolism (1.5%).
  
  
  RESULTS
  Implantation was successful in all patients, and at the end of intervention, complete PFO closure was achieved in 70.3% of them. There were no "major" complications (ie, deaths, device embolization or thrombosis, need for cardiac surgery). The overall incidence of complications (mostly hemorrhagic) was 7%. The mean follow-up period was 32 months. Complete closure had been achieved in 78.4% and in 82.5% of patients at the third month of transesophageal echocardiography examination and at the sixth month of transcranial Doppler examination, respectively. There were no recurrent thromboembolic events during the follow-up period.
  
  
  CONCLUSIONS
  Percutaneous closure of PFO is a feasible procedure, but it is not a risk-free technique. However, in correctly selected patients (ie, large PFO and those at risk for neurologic relapse), nearly complete PFO closure seems to provide protection from future neurologic ischaemic events at midterm follow-up.
authors.affiliation: Department of Internal Medicine, Cardiology Unit, University of Genova, Genova, Italy.
authors.forename: Manrico
authors.initials: M
authors.lastname: Balbi
authors.forename: Laura
authors.initials: L
authors.lastname: Casalino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gnecco
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Bezante
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pongiglione
authors.forename: Maurizio
authors.initials: M
authors.lastname: Marasini
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Sette
authors.forename: Antonio
authors.initials: A
authors.lastname: Barsotti
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D004617:Embolism / Q000209:etiology / Q000628:therapy; D019320:Embolism, Paradoxical / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications / Q000628:therapy*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D020521:Stroke / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome