[Ischemic stroke associated with patent foramen ovale: hospital database analysis]

Area of Science:

• Cardiology
• Neurology
• Vascular Medicine

Context:

• Ischemic stroke (IS) in young adults (18-55 years) can result from paradoxical embolism, often associated with right-left shunt (RLS) through a patent foramen ovale (PFO).
• Hospital registries from Moscow and Perm provided data for analyzing clinical and instrumental characteristics of IS patients with paradoxical embolism.

Purpose:

• To analyze the clinical and instrumental characteristics of patients experiencing ischemic stroke due to paradoxical embolism.
• To compare the diagnostic yield of PFO as a cause of IS between a specialized center and a regional hospital.

Summary:

• A study of 114 patients revealed Valsalva maneuver as the primary trigger for IS in paradoxical embolism. Significant differences in RLS/PFO characteristics and PASCAL classification outcomes were observed between the two centers.
• While specialized centers identified PFO as a probable cause in 93% of cases, regional centers found this in only 51%, highlighting variations in diagnostic accuracy.

Impact:

• The findings underscore the necessity of in-depth examination in specialized hospitals for accurate PFO assessment in IS patients.
• Improved patient selection for endovascular PFO occlusion can be achieved through more rigorous diagnostic protocols, potentially enhancing treatment efficacy.