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Embolization of patent foramen ovale closure devices: incidence, role of imaging in identification, potential causes, and management.

dc.contributor.author Goel, Sachin S
dc.contributor.author Aksoy, Olcay
dc.contributor.author Tuzcu, E Murat
dc.contributor.author Krasuski, Richard A
dc.contributor.author Kapadia, Samir R
dc.coverage.spatial United States
dc.date.accessioned 2015-12-03T17:21:40Z
dc.date.issued 2013
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24082375
dc.identifier.uri https://hdl.handle.net/10161/10995
dc.description.abstract Transcatheter patent foramen ovale (PFO) closure is an alternative to antiplatelet or anticoagulative therapy in patients with cryptogenic stroke, and it is associated with a small incidence of periprocedural sequelae. Because embolization of PFO closure devices is a very rare procedural complication, data on its frequency, causes, and management are sparse. We sought to review the medical literature and the cases of PFO closure-device embolization at our institution with the aim of identifying likely problems and reporting potential solutions. Out of 310 adult patients who underwent transcatheter PFO closure from June 2002 through April 2011, there were 2 cases (0.6%) of PFO closure-device embolization. In both patients, hypermobile septum primum and thick septum secundum were present. In one patient, failure to use a sizing balloon might have resulted in an underestimation of the PFO's size. In both patients, device embolization was identified in a timely fashion, the embolized device was safely retrieved, and the PFO was percutaneously closed with success. The incidence of PFO closure-device embolization is very low. The cases described here underscore the importance of imaging in the identification of morphologic predispositions to closure-device malpositioning, in the recognition of impending embolization, and in the timely management of embolization.
dc.language eng
dc.publisher TEXAS HEART INST
dc.relation.ispartof Tex Heart Inst J
dc.subject Contrast media/diagnostic use
dc.subject device removal/methods
dc.subject echocardiography, transesophageal
dc.subject fluoroscopy
dc.subject foramen ovale, patent/radiography/therapy/ultrasonography
dc.subject foreign body migration
dc.subject ischemic attack, transient/prevention & control
dc.subject prosthesis implantation/adverse effects
dc.subject septal occluder device/adverse effects
dc.subject stroke/prevention & control
dc.subject Aged, 80 and over
dc.subject Cardiac Catheterization
dc.subject Device Removal
dc.subject Echocardiography, Doppler, Color
dc.subject Echocardiography, Transesophageal
dc.subject Embolism
dc.subject Female
dc.subject Foramen Ovale, Patent
dc.subject Foreign-Body Migration
dc.subject Humans
dc.subject Incidence
dc.subject Male
dc.subject Middle Aged
dc.subject Prosthesis Design
dc.subject Risk Factors
dc.subject Septal Occluder Device
dc.subject Treatment Outcome
dc.title Embolization of patent foramen ovale closure devices: incidence, role of imaging in identification, potential causes, and management.
dc.type Journal article
duke.contributor.id Krasuski, Richard A|0199150
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24082375
pubs.begin-page 439
pubs.end-page 444
pubs.issue 4
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 40
dc.identifier.eissn 1526-6702
duke.contributor.orcid Krasuski, Richard A|0000-0003-3150-5215


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