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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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[Relationship between patent foramen ovale and cryptogenic stroke in a retrospective hospital-based study]

Péter Böjti1,2, Noémi Eszter Bartha3, Zsolt May1

  • 1Magyar Honvédség Egészségügyi Központ, Neurológiai Osztály, Budapest, Magyarország.

Ideggyogyaszati Szemle
|June 12, 2018
PubMed
Abstract

Insights

Patent foramen ovale (PFO)-related strokes are a significant cause of cryptogenic strokes (CS), especially in younger individuals. This study highlights the importance of PFO screening in unexplained stroke cases.

Area of Science:

  • Neurology
  • Cardiology
  • Vascular Medicine

Background:

  • Cryptogenic strokes (CS) account for 23-25% of ischemic strokes despite routine workup.
  • Patent foramen ovale (PFO) is identified as a cause in 25% of these cryptogenic cases.
  • Understanding the etiology of CS is crucial for effective treatment and prevention.

Purpose of the Study:

  • To establish the significant etiological role of PFO-related stroke (PFO-RS) in cryptogenic strokes (CS).
  • To investigate age-related differences in stroke etiology.
  • To assess the utility of contrast-enhanced functional transcranial Doppler in diagnosing PFO-RS.

Main Methods:

  • Retrospective analysis of ischemic stroke cases from 2014-2015.
  • ASCOD phenotyping for stroke classification.
  • Ultrasound techniques and Risk of Paradoxical Embolism (RoPE) score to determine PFO-RS prevalence in CS.
  • Analysis of etiological distribution across age groups (<40, 40-60, >60 years).

Main Results:

  • 8.12% of 985 ischemic strokes were classified as CS.
  • 41.38% of CS cases were found to be PFO-related.
  • PFO-RS were significantly more frequent in younger age groups, confirming a substantial etiological role and age-related differences in stroke causes.

Conclusions:

  • PFO-related strokes are a key cause of cryptogenic strokes, particularly in younger populations.
  • Age-specific etiologies were observed, with rarer causes in the young and classical causes in older individuals.
  • Contrast-enhanced functional transcranial Doppler is essential for diagnosing PFO-RS in routine workups.
Keywords:
paradoxical embolismpatent foramen ovalestroketranscranial Doppler sonographytransesophageal echocardiographyyoung adult

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