Skip to main content

Advertisement

Log in

PFO closuRE and CryptogenIc StrokE (PRECISE) registry: a multi-center, international registry

  • Original Paper
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Background

The Premere™ PFO closure device has a special design for closure of patent foramen ovale (PFO) including a flexible distance and angulation between the right and left disc providing minimal septal distortion. The primary objective of the study was to determine the degree of risk for stroke or transient ischemic attack (TIA) in patients after Premere™ PFO closure device implantation.

Methods

In this multicenter, prospective observational registry, patients with a clinical indication for PFO closure were included. Patients had a history of stroke or TIA with right to left shunt. Follow-up visits were scheduled according to routine clinical practice.

Results

In 23 centers from 10 countries, 267 patients with successful device implantation were included. Assessment of right to left shunt after device implantation revealed no residual shunt in 71 %, small shunts in 16.8 %, and moderate or large residual shunts in 5.6 and 6.5 %. With common clinical practice, use of Coumadin or heparin decreased from 27 % pre- to 3 % post-implantation, while use of acetylsalicylic acid or thienopyridines increased from 64 to 95 % and 27 to 80 %, respectively; 18 % of patients were discharged with anti-platelet monotherapy. Mean follow-up was 11 ± 9 months (range 1–24 months). There was no stroke or TIA. During follow-up, there was one sudden death. Atrial fibrillation occurred in five (1.9 %) patients. One (0.4 %) patient with a thrombophilic diathesis developed a thrombus.

Conclusions

In this prospective, international, multicenter PRECISE registry, the use of the Premere™ PFO closure device for closure of PFO after stroke or TIA resulted in good clinical results with no recurrent event.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Wöhrle J (2006) Closure of patent foramen ovale after cryptogenic stroke. Lancet 368:350–352

    Article  PubMed  Google Scholar 

  2. Burow A, Schwerzmann M, Wallmann D, Tanner H, Sakata T, Windecker S, Meier B, Delacrétaz E (2008) Atrial fibrillation following device closure of patent foramen ovale. Cardiology 111:47–50

    Article  PubMed  Google Scholar 

  3. Bronzetti G, D‘Angelo C, Donti A, Salomone L, Giardini A, Maria Picchio F, Boriani G (2011) Role of atrial fibrillation after transcatheter closure of patent foramen ovale in patients with or without cryptogenic stroke. Int J Cardiol 146:17–21

    Article  PubMed  Google Scholar 

  4. Alaeddini J, Feghali G, Jenkins S, Ramee S, White C, Abi-Samra F (2006) Frequency of atrial tachyarrhythmias following transcatheter closure of patent foramen ovale. J Invasive Cardiol 18:365–368

    PubMed  Google Scholar 

  5. Donti A, Giardini A, Salomone L, Formigari R, Picchio FM (2006) Transcatheter patent foramen ovale closure using the Premere PFO occlusion system. Catheter Cardiovasc Interv 68:736–740

    Article  PubMed  Google Scholar 

  6. Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, Sievert H (2004) Incidence and clinical course of thrombus formation on atrial septal defect and patient foramen ovale closure devices in 1,000 consecutive patients. J Am Coll Cardiol 43:302–309

    Article  PubMed  Google Scholar 

  7. Anzai H, Child J, Natterson B, Krivokapich J, Fishbein MC, Chan VK, Tobis JM (2004) Incidence of thrombus formation on the CardioSEAL and the Amplatzer interatrial closure devices. Am J Cardiol 93:426–431

    Article  PubMed  Google Scholar 

  8. Ruge H, Wildhirt SM, Libera P, Vogt M, Holper K, Lange R (2005) Images in cardiovascular medicine. Left atrial thrombus on atrial septal defect closure device as a source of cerebral emboli 3 years after implantation. Circulation 112:e130–e131

    Article  PubMed  CAS  Google Scholar 

  9. Van H, Poommipanit P, Shalaby M, Gevorgyan R, Tseng CH, Tobis J (2010) Sensitivity of transcranial Doppler versus intracardiac echocardiography in the detection of right-to-left shunt. JACC Cardiovasc Imaging 3:343–348

    Article  PubMed  Google Scholar 

  10. Nusser T, Höher M, Merkle N, Grebe OC, Spiess J, Kestler HA, Rasche V, Kochs M, Hombach V, Wöhrle J (2006) Cardiac magnetic resonance imaging and transesophageal echocardiography in patients with transcatheter closure of patent foramen ovale. J Am Coll Cardiol 48:322–329

    Article  PubMed  Google Scholar 

  11. Wöhrle J, Kochs M, Hombach V, Merkle N (2010) Prevalence of myocardial scar in patients with cryptogenic cerebral ischemic events and patent foramen ovale. JACC Cardiovasc Imaging 3:833–839

    Article  PubMed  Google Scholar 

  12. Wöhrle J, Kochs M, Spiess J, Nusser T, Hombach V, Merkle N (2009) Impact of percutaneous device implantation for closure of patent foramen ovale on valve insufficiencies. Circulation 119:3002–3008

    Article  PubMed  Google Scholar 

  13. Ford MA, Reeder GS, Lennon RJ, Brown RD, Petty GW, Cabalka AK, Cetta F, Hagler DJ (2009) Percutaneous device closure of patent foramen ovale in patients with presumed cryptogenic stroke or transient ischemic attack: the Mayo Clinic experience. J Am Coll Cardiol Intv 2:404–411

    Google Scholar 

  14. Wahl A, Krumsdorf U, Meier B, Sievert H, Ostermayer S, Billinger K, Schwerzmann M, Becker U, Seiler C, Arnold M, Mattle HP, Windecker S (2005) Transcatheter treatment of atrial septal aneurysm associated with patent foramen ovale for prevention of recurrent paradoxical embolism in high-risk patients. J Am Coll Cardiol 45:377–380

    Article  PubMed  Google Scholar 

  15. Büschek F, Sievert H, Kleber F, Tiefenbacher C, Krumsdorf U, Windecker S, Uhlemann F, Wahr DW (2006) Patent foramen ovale using the Premere device: the results of the CLOSEUP trial. J Interven Cardiol 19:328–333

    Article  Google Scholar 

  16. Rigatelli G, Dell‘Avvocata F, Ronco F, Giordan M, Cardaioli P (2010) Patent oval foramen transcatheter closure: results of a strategy based on tailoring the device to the specific patient’s anatomy. Cardiol Young 20:144–149

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by St Jude Medical International Inc., Zaventem, Belgium.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jochen Wöhrle.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wöhrle, J., Bertrand, B., Søndergaard, L. et al. PFO closuRE and CryptogenIc StrokE (PRECISE) registry: a multi-center, international registry. Clin Res Cardiol 101, 787–793 (2012). https://doi.org/10.1007/s00392-012-0458-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-012-0458-9

Keywords

Navigation