scholarly journals 291 Patent foramen ovale size is still a risk factor for recurrent cerebrovascular events in patients with cryptogenic stroke

2003 ◽  
Vol 4 ◽  
pp. S130
Author(s):  
H SCHUCHLENZ ◽  
W WEIHS ◽  
R SCHMIDT ◽  
A LECHNER ◽  
A BERGHOLD
Keyword(s):  
Risk Factor ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Cerebrovascular Events

Stroke Prophylaxis by Percutaneous Closure of Patent Foramen Ovale and Left Atrial Appendage

2011 ◽  
Vol 6 (1) ◽  
pp. 67
Author(s):  
Antonio L Bartorelli ◽  
Claudio Tondo ◽  
◽  
Keyword(s):  
Left Atrial ◽  
Patent Foramen Ovale ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Cryptogenic Stroke ◽  
Atrial Appendage ◽  
Foramen Ovale ◽  
Percutaneous Procedures ◽  
Cerebrovascular Events

Innovative percutaneous procedures for stroke prevention have emerged in the last two decades. Transcatheter closure of the patent foramen ovale (PFO) is performed in patients who suffered a cryptogenic stroke or a transient ischaemic attach (TIA) in order to prevent recurrence of thromboembolic events. Percutaneous occlusion of the left atrial appendage (LAA) has been introduced to reduce stroke risk in patients with atrial fibrillation (AF). The role of PFO and LAA in the occurrence of cerebrovascular events and the interventional device-based therapies to occlude the PFO and LAA are discussed.

scholarly journals Ischemic stroke and patent foramen ovale: case report

2006 ◽  
Vol 64 (3b) ◽  
pp. 858-861
Author(s):  
Carlos Eduardo Amaral Pereira da Silva ◽  
Thiago Cardoso Vale ◽  
Flávio José Barbosa Leite ◽  
Thais Gomes Casali ◽  
Gustavo de Moraes Ramalho ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Case Report ◽  
Patent Foramen Ovale ◽  
Clinical Presentation ◽  
Cryptogenic Stroke ◽  
Cerebral Embolism ◽  
Foramen Ovale ◽  
Left And Right ◽  
Right Atria

Approximately 40% of ischemic strokes have no clearly definable etiology and are termed cryptogenic strokes. Patent foramen ovale, a small communication between the left and right atria, is considered to be a risk factor for cerebral embolism. In this study, we report the case of a 29-year-old woman with diagnosis of ischemic stroke due to patent foramen ovale who has undergone percutaneous endovascular closure. The aim of this report is to discuss the relevant aspects of the patent foramen ovale and the cryptogenic stroke, its clinical presentation, diagnosis, management and recurrence.

scholarly journals Five Year Follow-Up of Cryptogenic Stroke Patients Following Patent Foramen Ovale Closure

2021 ◽  
Vol 6 (1) ◽  
pp. 2
Author(s):  
Agnete Teivāne ◽  
Kristaps Jurjāns ◽  
Ainārs Rudzītis ◽  
Krista Lazdovska ◽  
Artūrs Balodis ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Residual Shunt ◽  
Amplatzer Occluder ◽  
Cerebrovascular Events ◽  
Ischemic Attack ◽  
Pfo Closure

Background and Objectives: According to guidelines, patent foramen ovale (PFO) closure is recommended for secondary stroke prevention in patients with cryptogenic stroke. Paradoxial embolism from PFO-mediated right to left shunt has been described as the mechanism of stroke in these cases. The aim of the study was to determine whether PFO closure can be associated with improvement of complaints (headaches, fatigue, heart palpitations, dizziness, and visual impairment) and determine its long-term effectiveness on recurrent stroke risk reduction. Materials and Methods: A total of 103 patients were enrolled in a retrospective study and followed-up by phone up to five years after PFO closure. Standardized survey was conducted about their well-being, recurrent cerebrovascular events, and the use of prescribed medication. Patients were also followed up for residual shunts 24 h, 30 days, 1 year, and 2 years after PFO. The pathogenic ischemic stroke subtypes are determined using CCS (Causative Classification System for Ischemic Stroke). Results: Male patients accounted for 43.7% (n = 45). The mean age was—44.4 ± 13 (18–75). The most probable cause for cryptogenic stroke for 53.4% (n = 55) of patients with possible cardio-aortic embolism was PFO. Residual shunts were mostly observed in patients with Amplatzer occluder—87.5% (n = 14). There was correlation between residual shunt and increased risk of transient ischemic attack recurrence (p = 0.067). Five-years after PFO closure recurrent cerebrovascular events were reported in only 5.1% (n = 5) of patients, this difference is statistically relevant (p < 0.001). Out of 51 patients presented with complaints before PFO closure, 25.5% (n = 13) did not present with any complaints after PFO closure. Conclusions: PFO can be considered a possible risk factor for cryptogenic stroke. PFO closure is effective in reducing recurrent cerebrovascular events. Residual shunt after PFO closure increases the risk of transient ischemic attack recurrence. Amplatzer occluder device is associated with a higher risk for residual shunts after PFO closure. PFO closure can be associated with improvement of complaints.

Abstract 1173: Risk of Recurrent Cerebrovascular Events in Patients with Cryptogenic Cerebral Ischemia and Patent Foramen Ovale: A Meta-Analysis of Observational Studies

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Stephen B Wilton ◽  
Mohammed A Almekhlafi ◽  
Doreen M Rabi ◽  
William A Ghali ◽  
Diane L Lorenzetti ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Patent Foramen Ovale ◽  
Recurrent Events ◽  
Comparison Group ◽  
Meta Analysis ◽  
Cryptogenic Stroke ◽  
Absolute Rate ◽  
Foramen Ovale ◽  
Cerebrovascular Events ◽  
Increased Risk

In patients with a patent foramen ovale (PFO) and a prior cryptogenic ischemic stroke or transient ischemic attack (TIA), the risk of recurrent events is unclear. To conduct a systematic review and meta-analysis of studies assessing the risk of recurrent cerebrovascular events in patients with cryptogenic cerebral ischemia and PFO. MEDLINE (1950 to February 2008) and EMBASE (1980 to February 2008) databases were searched to identify studies in any language. Searches were supplemented by scanning bibliographies of key articles. Studies reporting original data on recurrent cerebrovascular events in patients with prior cryptogenic stroke or TIA and PFO, with or without a non-PFO comparison group, were included. Uncontrolled case series evaluating device or surgical closure of PFO were excluded. Two authors independently extracted the data from included studies and evaluated study quality. For studies with a non-PFO comparison group, relative risks were pooled using a fixed effects model after confirming homogeneity of results. For all studies, the pooled absolute rate of recurrent events was calculated using a random effects model due to heterogeneity of results. Fifteen studies published between 1994 and 2007, following 2377 patients over a mean of 37 months were included. In the four studies with a non-PFO comparison group, the pooled relative risk of recurrent stroke or TIA associated with the presence of a PFO was 1.1 (95% CI 0.8 to 1.5), while for recurrent ischemic stroke the pooled relative risk associated with the presence of a PFO was 0.8 (95% CI 0.5 to 1.3). The pooled absolute rate of recurrent ischemic stroke or TIA in patients with PFO was 4.0 events per 100 person-years (95% CI 3.0 to 5.1) while the rate of recurrent ischemic stroke was 1.6 events per 100 person years (95% CI 1.1 to 2.1). No clinical or imaging features are reliably associated with increased risk of recurrent events. In medically treated patients with prior cryptogenic stroke, available evidence does not support an increased risk of recurrent ischemic events in those with vs. without a PFO. Routine PFO closure in these patients may not be warranted, outside of ongoing clinical trials.

Risk of Recurrent Cerebrovascular Events in Patients with Cryptogenic Stroke or Transient Ischemic Attack and Patent Foramen Ovale: The FORI (Foramen Ovale Registro Italiano) Study

2011 ◽  
Vol 31 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Maurizio Paciaroni ◽  
Giancarlo Agnelli ◽  
Andrea Bertolini ◽  
Alessandro Pezzini ◽  
Alessandro Padovani ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Foramen Ovale ◽  
Cerebrovascular Events ◽  
Ischemic Attack

scholarly journals Short-Term and Two-Year Rate of Recurrent Cerebrovascular Events in Patients with Acute Cerebral Ischemia of Undetermined Aetiology, with and without a Patent Foramen Ovale

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Silvia Di Legge ◽  
Fabrizio Sallustio ◽  
Emiliano De Marchis ◽  
Costanza Rossi ◽  
Giacomo Koch ◽  
...  
Keyword(s):  
Patent Foramen Ovale ◽  
Recurrent Events ◽  
Recurrent Stroke ◽  
Cryptogenic Stroke ◽  
Stroke Recurrence ◽  
Foramen Ovale ◽  
Related Factors ◽  
Age Related ◽  
Cerebrovascular Events ◽  
Acute Cerebral Ischemia

Purpose. We investigated stroke recurrence in patients with acute ischemic stroke of undetermined aetiology, with or without a patent foramen ovale (PFO). Methods. Consecutive stroke patients underwent to Transcranial Doppler and Transesophageal Echocardiography for PFO detection. Secondary stroke prevention was based on current guidelines. Results. PFO was detected in 57/129 (44%) patients. The rate of recurrent stroke did not significantly differ between patients with and without a PFO: 0.0% versus 1.4% (1 week), 1.7% versus 2.7% (1 month), and 3.5% versus 4.2% (3 months), respectively. The 2-year rates were 10.4% (5/48) in medically treated PFO and 8.3% (6/72) in PFO-negative patients (), with a relative risk of 1.25. No recurrent events occurred in 9 patients treated with percutaneous closure of PFO. Conclusion. PFO was not associated with increased rate of recurrent stroke. Age-related factors associated with stroke recurrence in cryptogenic stroke should be taken into account when patients older than 55 years are included in PFO studies.

scholarly journals A Case Series Coexistence of PFO with Other Conditions - Who’s the Culprit?

2021 ◽  
Vol 42 (3) ◽  
Author(s):  
Dessytha Nathania Hudaja ◽  
Aurea Stella Soetjipto ◽  
Queen Sugih Ariyani ◽  
Michael Soesanto ◽  
Ingrid Maria Pardede
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Patent Foramen Ovale ◽  
Protein C ◽  
Cryptogenic Stroke ◽  
Case Series ◽  
Review Article ◽  
Foramen Ovale ◽  
S Deficiency

Abstract.  Background: Patent foramen ovale (PFO) is a major cause of cryptogenic stroke (CS). However, it is still possible that PFO comes with those other conditions during evaluation. This paper presents a series of CS cases highly suspected due to PFO origin with each of its special presentations. Case illustration/summary of a review article: We present three cases of CS with PFO as a possible contributing factor. Case 1 showed a patient with repeated ischemic strokes that was investigated to be cryptogenic in origin. Case 2 showed CS with PFO and occult atrial fibrillation. Case 3 showed CS at a young age caused by a PFO with protein C/S deficiency. Conclusion: The role of PFO as a culprit, risk factor, or a coincidental finding in CS is still debatable and is a controversial issue. Determining PFO as a cause of CS requires a thorough consideration of clinical and PFO anatomical/morphological factors.

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