Residual Shunt after Patent Foramen Ovale Device Closure in Patients With Cryptogenic Stroke: Serial Bubble Contrast Transesophageal Echocardiography Data

Percutaneous closure of patent foramen ovale (PFO) is an alternative option to medical treatment for secondary prevention for cryptogenic stroke (CS). Despite technical success of procedure, residual shunt (RS) which is a presumable cause for recurrent stroke is observed in some patients. We evaluated the RS with serial follow-up bubble contrast transesophageal echocardiography (BCTEE) after PFO closure.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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Publication date: Available online 13 December 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Carlos Minguito-Carazo, Tomás Benito-González, Julio Cesar Echarte-Morales, Mario Castaño-Ruiz, Felipe Fernández-VázquezAbstractA 78-year-old woman with history of transient ischemic attack was admitted for sudden aphasia. In order to assess a potential cardioembolic source an echocardiogram was performed revealing a large mass consistent with a thrombus in transit through a patent foramen ovale. Due to the high risk of systemic embolism emergent surgical thrombectomy was performed,...
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research
CONCLUSIONS: Although a big step forward that will benefit many patients has been taken with recent trials, many questions remain unanswered. Pending results from further studies, decision-making regarding management of patients with PFO-associated ischaemic stroke should be based on a close coordination between neurologists/stroke specialists and cardiologists. PMID: 31787326 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al....
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of ReviewWe aim to evaluate the epidemiology, racial and gender disparity, etiology, and treatment of stroke in the younger population.Recent FindingsThe younger age group without vascular risk factors exhibits an increased prevalence of cardio-embolism in context of patent foramen ovale/atrial septal aneurysm strokes, from other determined etiology of non-atherosclerotic vasculopathy including dissection, inherited or acquired thrombophilia, and other unusual causes of stroke. Ethnic disparities also exist in certain populations.SummaryThe prevalence of stroke in the young is increasing due to several fact...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
AbstractPurpose of reviewTo highlight recent advancements in the management of acute ischemic stroke patients with patent foramen ovale (PFO).Recent findingsOne significant recent development was publication of long-term follow-up data from the RESPECT trial demonstrating evidence in favor of PFO closure over medical management. This data subsequently led to FDA approval for AMPLATZER ™ septal occluder in the treatment of patients aged 18 to 60 years with both PFO and no other determined etiology for ischemic stroke, otherwise referred to as embolic stroke of undetermined source. Several subsequent closure trial...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Abstract The presence of patent foramen ovale (PFO) was found to be associated with a number of medical conditions, including embolic stroke and recurrent transient neurological defects. The closure of PFO remains controversial, however recently guidelines from European Association of Percutaneous Cardiovascular Interventions in collaboration with 7 other European societies have been published, which extensively referring to the latest randomized clinical trials, explicitly recommend percutaneous PFO closure in the prevention of recurrent thromboembolic events. In connection with the above facts and expecting incr...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
In Reply We agree with Popkirov that left atrial volume is a better marker of incident atrial fibrillation than atrial diameter; however, we did not have these data available at all of the sites participating in the New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source (NAVIGATE-ESUS) trial. Recently completed and ongoing studies will help determine if our observation has a clinical role and may provide additional data on left atrial size and function. Once all of these data are available, guidelines committees will likely make recommendat...
Source: JAMA Neurology - Category: Neurology Source Type: research
Ka U Lio, Maruti Kumaran, Parth RaliLung India 2019 36(6):564-566
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
Conclusion Young patients with cryptogenic strokes seem to benefit from endovascular closure of a PFO in the presence of a large right-to-left shunt or an associated atrial septum aneurysm. For most other patients, a highly-individualized decision must be made, taking into account the low risk of recurrence in patients with a cryptogenic stroke attributable to a PFO, the high numbers needed to treat and the risks related to the procedure.RESUMO O tratamento de pacientes com infarto cerebral criptog ênico e forame oval patente (FOP) é controverso. Uma revisão crítica destes estudos é aprese...
Source: Arquivos de Neuro-Psiquiatria - Category: Neurology Source Type: research
Abstract Stroke still remains a major cause of death and disability worldwide. Ischemic stroke is the most common type of stroke. Causes of ischemic stroke can be classified into large-artery atherosclerosis, cardiogenic embolism, small-vessel disease, stroke of other determined etiology, and stroke of undetermined etiology. Stroke causes in adults are mainly attributable to classical cardiovascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. In neuroimaging, stroke subtypes can be defined according to lesion localization and distribution (territorial infarct, lacunar infarct, h...
Source: Hamostaseologie - Category: Hematology Authors: Tags: Hamostaseologie Source Type: research
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