Journals / Diagnostic and Interventional Radiology / 2016 / Cilt: 22 - Sayı: 1

Silent cerebral emboli following percutaneous closure of atrial septal defect in pediatric patients: a diffusion-weighted MRI study

Pages
90–94
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, due to the relatively small sample size, further studies with larger patient groups are needed for the validation of our preliminary results.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The aim of this prospective study was to investigate the incidence of silent cerebrovascular embolic events associated with percutaneous closure of atrial septal defect (ASD) in pediatric patients.
📊
Key Findings & Data:METHODSA total of 23 consecutive pediatric patients (mean age, 10.4±3.8 years; range, 4-17 years) admitted for transcatheter closure of ASD were recruited in the study.
💡
Conclusion & Impact:However, due to the relatively small sample size, further studies with larger patient groups are needed for the validation of our preliminary results.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

The aim of this prospective study was to investigate the incidence of silent cerebrovascular embolic events associated with percutaneous closure of atrial septal defect (ASD) in pediatric patients. METHODSA total of 23 consecutive pediatric patients (mean age, 10.4±3.8 years; range, 4-17 years) admitted for transcatheter closure of ASD were recruited in the study. The patients were scanned with a 1.5 Tesla clinical scanner. Two cranial magnetic resonance imaging (MRI) examinations were acquired before the procedure and within 24 hours following the catheterization. MRI included turbo spin-echo fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging technique with single-shot echo-planar spin-echo sequence. The transcatheter closure of ASD was performed by three expert interventional cardiologists. Amplatzer septal occluder device was implemented for the closure of the defect. No contrast medium was administered in the course of the procedure. RESULTSNone of the patients had diffusion restricted cerebral lesions resembling microembolic infarctions on postprocedural MRI. Preprocedural MRI of two patients revealed nonspecific hyperintense white matter lesions on FLAIR images with increased diffusion, which were considered to be older ischemic lesions associated with previously occurred paradoxical embolism. CONCLUSIONThe current study suggests that percutaneous closure of the ASD, when performed by experienced hands, may be free of cerebral microembolization in pediatric patients. However, due to the relatively small sample size, further studies with larger patient groups are needed for the validation of our preliminary results.

🔖

Cite This Article

KOÇ, G., ÖZYURT, A., DOĞANAY, S., BAYKAN, A., GÖRKEM, S. B., DOGAN, M. S., PAMUKÇU, Ö., ÜZÜM, K., COŞKUN, A., NARİN, N. (2016). Silent cerebral emboli following percutaneous closure of atrial septal defect in pediatric patients: a diffusion-weighted MRI study. Diagnostic and Interventional Radiology, Cilt: 22 - Sayı: 1, 90–94. https://ajindex.com/articles/204241

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (2)

  1. Hamon M, Baron JC, Viader F, Hamon M. Periprocedural stroke and cardiac catheteriza- tion. Circulation 2008; 118:678-683. [CrossRef] Sila C. Neurologic complications of cardiac tests and procedures. Handb Clin Neurol 2014; 119:41-47. [CrossRef] Vasaiwala SC, Wilber DJ. Neurologic complications of catheter ablation/defibrillators/pacemakers. Handb Clin Neurol 2014; 119:151-160. [CrossRef] Kutty S, Brown K, Asnes JD, Rhodes JF, Latson LA. Causes of recurrent focal neurologic events after transcatheter closure of patent foramen ovale with the CardioSEAL septal occluder. Am J Cardiol 2008; 101:1487-1492. [CrossRef] Busing KA, Schulte-Sasse C, Flucher S, et al. Cerebral infarction incidence and risk factors after diagnostic and interventional cardiac catheterization-prospective evaluation at dif- fusion-weighted MR imaging. Radiology 2005; 235:177-183. [CrossRef] Hamon M, Lipiecki J, Carrié D, et al. Silent cerebral infarcts after cardiac catheterization: a random- ized comparison of radial and femoral approach- es. Am Heart J 2012; 164:449-454. [CrossRef] Balbi M, Casalino L, Gnecco G, et al. Percuta- neous closure of patent foramen ovale in pa- tients with presumed paradoxical embolism: periprocedural results and midterm risk of recurrent neurologic events. Am Heart J 2008; 156:356-360. [CrossRef] Hamon M, Burzotta F, Oppenheim C, Morello R, Viader F, Hamon M; SCIPION Investigators. Silent cerebral infarct after cardiac catheter- ization as detected by diffusion weighted magnetic resonance imaging: a randomized comparison of radial and femoral arterial ap- proaches. Trials 2007; 7:15. [CrossRef] Fairbairn TA, Mather AN, Bijsterveld P, et al. Dif- fusion-weighted MRI determined cerebral em- bolic infarction following transcatheter aortic valve implantation: assessment of predictive risk factors and the relationship to subsequent health status. Heart 2012; 98:18-23. [CrossRef] Oktay Tureli H, Ungan I, et al. Risk of cerebral embolism after interventional closure of symp- tomatic patent foramen ovale or atrial septal defect: a diffusion-weighted MRI and neuron specific enolase based study. J Invasive Cardiol 2013; 25:519-524.
  2. Ferrari J, Baumgartner H, Tentschert S, et al. Cerebral microembolism during transcatheter closure of patent foramen ovale. J Neurol 2004; 251:825-829. [CrossRef] Dorenbeck U, Simon B, Skowasch D, et al. Ce- rebral embolism with interventional closure of symptomatic patent foramen ovale: an MRI- based study using diffusion-weighted imag- in