卵圆孔未闭与脑卒中.ppt

Device Closure of PFO After Stroke -临床荟萃研究 Among patients with PFO and CS, closure reduced recurrent stroke a significant benefit of PFO closure when compared with ASA (1.4 vs. 3.6%, P=0.03) Vitamin K antagonists performed as well as PFO closure (3.0 vs. 2.5%, P=0.86). J Am Coll Cardiol 2016;67:907–17 2,303 patients 2 devices (STARFlex ) and Amplatzer PFO Occluder evaluated in 3 trials The primary composite outcome was stroke, TIA, or death; the secondary outcome was stroke. Stroke/TIA/Death Recurrent Stroke Logrank P=0.0885 Logrank P=0.0103 Data from trials of disc occluder * PPT课件 Percutaneous closure of PFO in cryptogenic embolism -临床荟萃研究 PFO closure with AMP appears superior to medical therapy in preventing strokes in CS No significant differences found for STF and HLX when compared with medical therapy The probability to be best in preventing strokes was 77.1% for AMP, 20.9% for HLX, 1.7% for STF, and 0.4% for medical therapy.. four randomized trials (2963 patients with 9309 patient-years Investigated devices were Amplatzer (AMP), STARFlex (STF), and HELEX (HLX). European Heart Journal (2015) 36, 120–128 * PPT课件 长期疗效对比：PFO封堵vs药物治疗 PFO?closure?was more effective than medical treatment for the secondary prevention PFO closure resulted in a significant 64% relative risk reduction for death? Circulation 2012;125:803–812. 308 patients , percutaneous PFO?closure?(150 patients) or medical treatment (158 patients) followed up prospectively for up to 15 years. Ten-year outcome * PPT课件 RESPECT研究最终结果 Data from August 2003 - May 2016 Mean Follow-up: 5.9 years (0-12 years) Device Mean 6.3 years; Total 3141 patient-years Medical Management Mean 5.5 years; Total 2669 patient-years PFO closure with the AMPLATZERTM PFO Occluder was more beneficial than medical management alone * PPT课件 PFO形态与不明原因卒中的关系 PFO diameter larger PFOs may be more prone to trans