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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence

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Deep vein thrombosis in patients with stroke or transient ischemic attack presenting with patent foramen ovale: a

Charlotte Huber1, Stephan Stöbe2, Andreas Hagendorff2

  • 1Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.

BMC Neurology
|August 26, 2024
PubMed

Insights

Deep vein thrombosis (DVT) occurs in a significant number of stroke patients with a patent foramen ovale (PFO). The Wells score can help identify patients who need further screening for DVT.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Patent foramen ovale (PFO) is linked to paradoxical embolism causing cerebral ischemia.
  • Deep vein thrombosis (DVT) is a potential source of embolism in PFO patients, but screening rates vary.
  • Lack of clear guidelines necessitates characterizing DVT prevalence in stroke/TIA patients with PFO.

Purpose of the Study:

  • To determine the rate of DVT in patients with stroke or transient ischemic attack (TIA) and PFO.
  • To identify clinical, demographic, and laboratory parameters associated with DVT in this population.
  • To evaluate the utility of risk scores in predicting DVT.

Main Methods:

  • Retrospective analysis of medical records for patients with stroke/TIA and PFO.
  • DVT diagnosis via lower limb compression ultrasonography.
  • Comparison of demographic, clinical, laboratory data, RoPE, and Wells scores between DVT+ and DVT- groups.

Main Results:

  • 339 patients (61.2±15.4 years, 61.1% male) with stroke/TIA and PFO were identified.
  • DVT was detected in 7.8% (17/217) of patients undergoing ultrasonography.
  • DVT was associated with prior DVT, cancer, immobilization, calf pain/swelling, and elevated D-dimer. The Wells score was a significant predictor (OR 35.46).

Conclusions:

  • DVT is present in a relevant proportion of patients with cerebral ischemia and PFO.
  • Screening for DVT should be considered in the diagnostic workup of these patients.
  • The Wells score may effectively guide the need for compression ultrasonography.
Abstract

Keywords:
Deep vein thrombosisIschemic strokePatent foramen ovaleTransient ischemic attack

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