Abstract：
Scarce data exist on noncerebrovascular peripheral embolism (NCPE) patients undergoing transcatheter patent foramen ovale (PFO) closure. The objectives of this study were to determine the clinical and procedural characteristics, and long-term outcomes of patients with NCPE undergoing transcatheter PFO closure.
This was a multicenter study including 1136 consecutive patients who underwent PFO closure after a thromboembolic event. Patients were divided into 2 groups according to the type of event leading to PFO closure, ie, cerebrovascular event (CVE, n = 1099 [96.7%]) and NCPE (n = 37 [3.3%]). The median follow-up was 3 years (interquartile range, 1-8), with follow-up complete in 98%.
Patients in the NCPE group exhibited higher rates of prior or concomitant pulmonary embolism (29.7% vs 3.4%; P<.001), and prior myocardial infarction (24.3% vs 1.8%; P<.001). Most NCPE events were located in the limbs (41%), followed by coronary (27%) and renal/splenic/mesenteric arteries (12%). PFO closure was successful in all patients, with a low complication rate (<1%) in both groups. NCPE patients were more frequently treated with anticoagulation following PFO closure (63% vs 13%; P<.001). There were no differences between NCPE and CVE groups in death (0 per 100 patient years vs 0.4 per 100 patient-years; P=.53) or cerebrovascular events (1.3 per 100 patient-years vs 0.4 per 100 patient-years; P=.15) at follow-up.
Patients with NCPE events undergoing PFO closure exhibited differential baseline characteristics compared with patients with CVEs; limbs and coronary arteries were the most frequent NCPE location. PFO closure results and long-term outcomes were similar to their CVE counterparts, with a very low rate of recurrent thromboembolic events. Further studies are needed in this population.
This was a multicenter study including 1136 consecutive patients who underwent PFO closure after a thromboembolic event. Patients were divided into 2 groups according to the type of event leading to PFO closure, ie, cerebrovascular event (CVE, n = 1099 [96.7%]) and NCPE (n = 37 [3.3%]). The median follow-up was 3 years (interquartile range, 1-8), with follow-up complete in 98%.
Patients in the NCPE group exhibited higher rates of prior or concomitant pulmonary embolism (29.7% vs 3.4%; P<.001), and prior myocardial infarction (24.3% vs 1.8%; P<.001). Most NCPE events were located in the limbs (41%), followed by coronary (27%) and renal/splenic/mesenteric arteries (12%). PFO closure was successful in all patients, with a low complication rate (<1%) in both groups. NCPE patients were more frequently treated with anticoagulation following PFO closure (63% vs 13%; P<.001). There were no differences between NCPE and CVE groups in death (0 per 100 patient years vs 0.4 per 100 patient-years; P=.53) or cerebrovascular events (1.3 per 100 patient-years vs 0.4 per 100 patient-years; P=.15) at follow-up.
Patients with NCPE events undergoing PFO closure exhibited differential baseline characteristics compared with patients with CVEs; limbs and coronary arteries were the most frequent NCPE location. PFO closure results and long-term outcomes were similar to their CVE counterparts, with a very low rate of recurrent thromboembolic events. Further studies are needed in this population.
摘要：
目的：接受经导管卵圆孔未闭（PFO）封堵术的非脑血管周围栓塞（NCPE）患者的数据很少。本研究的目的是确定临床和手术特征，经导管PFO封堵术的NCPE患者的长期结局。
方法：这是一项多中心研究，包括1136例血栓栓塞事件后接受PFO封堵的患者。根据导致PFO闭合的事件类型将患者分为2组，ie,脑血管事件（CVE，n=1099[96.7%])和NCPE(n=37[3.3%])。中位随访时间为3年(四分位距，1-8),98％的随访完成。
结果：NCPE组患者先前或合并肺栓塞的发生率更高（29.7%vs3.4%；P<.001），和既往心肌梗死（24.3%vs1.8%；P<.001）。大多数NCPE事件位于四肢（41％），其次是冠状动脉（27％）和肾/脾/肠系膜动脉（12％）。所有患者都成功封堵PFO,两组并发症发生率均较低（<1%）。在PFO闭合后，NCPE患者使用抗凝治疗的频率更高（63％vs13％；P<.001）。NCPE和CVE组在随访时死亡（0/100患者年vs0.4/100患者年；P=.53）或脑血管事件（1.3/100患者年vs0.4/100患者年；P=.15）没有差异。
结论：与CVE患者相比，发生NCPE事件的PFO封堵患者表现出不同的基线特征；肢体和冠状动脉是最常见的NCPE位置。PFO闭合结果和长期结果与CVE相似，血栓栓塞事件的复发率非常低。需要对这一人群进行进一步的研究。
方法：这是一项多中心研究，包括1136例血栓栓塞事件后接受PFO封堵的患者。根据导致PFO闭合的事件类型将患者分为2组，ie,脑血管事件（CVE，n=1099[96.7%])和NCPE(n=37[3.3%])。中位随访时间为3年(四分位距，1-8),98％的随访完成。
结果：NCPE组患者先前或合并肺栓塞的发生率更高（29.7%vs3.4%；P<.001），和既往心肌梗死（24.3%vs1.8%；P<.001）。大多数NCPE事件位于四肢（41％），其次是冠状动脉（27％）和肾/脾/肠系膜动脉（12％）。所有患者都成功封堵PFO,两组并发症发生率均较低（<1%）。在PFO闭合后，NCPE患者使用抗凝治疗的频率更高（63％vs13％；P<.001）。NCPE和CVE组在随访时死亡（0/100患者年vs0.4/100患者年；P=.53）或脑血管事件（1.3/100患者年vs0.4/100患者年；P=.15）没有差异。
结论：与CVE患者相比，发生NCPE事件的PFO封堵患者表现出不同的基线特征；肢体和冠状动脉是最常见的NCPE位置。PFO闭合结果和长期结果与CVE相似，血栓栓塞事件的复发率非常低。需要对这一人群进行进一步的研究。
