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

dc.contributor.author

Goel, Sachin S

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Aksoy, Olcay

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Tuzcu, E Murat

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Krasuski, Richard A

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Kapadia, Samir R

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United States

dc.date.accessioned

2015-12-03T17:21:40Z

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2013

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.identifier

http://www.ncbi.nlm.nih.gov/pubmed/24082375

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1526-6702

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https://hdl.handle.net/10161/10995

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eng

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TEXAS HEART INST

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Tex Heart Inst J

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Contrast media/diagnostic use

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device removal/methods

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echocardiography, transesophageal

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fluoroscopy

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foramen ovale, patent/radiography/therapy/ultrasonography

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foreign body migration

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ischemic attack, transient/prevention & control

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prosthesis implantation/adverse effects

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septal occluder device/adverse effects

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stroke/prevention & control

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Aged, 80 and over

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Cardiac Catheterization

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Device Removal

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Echocardiography, Doppler, Color

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Echocardiography, Transesophageal

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Embolism

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Female

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Foramen Ovale, Patent

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Foreign-Body Migration

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Humans

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Incidence

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Male

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Middle Aged

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Prosthesis Design

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Risk Factors

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Septal Occluder Device

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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.orcid

Krasuski, Richard A|0000-0003-3150-5215

pubs.author-url

http://www.ncbi.nlm.nih.gov/pubmed/24082375

pubs.begin-page

439

pubs.end-page

444

pubs.issue

4

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Clinical Science Departments

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Duke

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Medicine

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Medicine, Cardiology

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School of Medicine

pubs.publication-status

Published

pubs.volume

40

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