Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke

New England Journal of Medicine, Ahead of Print.
Source: New England Journal of Medicine - Category: Internal Medicine Source Type: research

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This article discusses cryptogenic stroke and the results of recent randomized trials that can inform its evaluation and management. RECENT FINDINGS Most cryptogenic strokes appear embolic, leading to the term embolic stroke of undetermined source. It was previously thought that embolic stroke of undetermined source was a single, therapeutically relevant entity, the underlying sources of which would respond to anticoagulant therapy; however, two large randomized trials found no benefit with anticoagulation compared to antiplatelet therapy for secondary stroke prevention after embolic stroke of undetermined source. A sin...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
AbstractHigh-risk PE can be complicated by the presence of a patent foramen ovale (PFO), which can lead to paradoxical systemic embolization, including cerebral embolism ultimately leading to acute ischemic stroke (AIS). Acute management is challenging given the competing benefits and risks of systemic thrombolysis. Herein, we aim to provide a review of clinical presentations, diagnostic findings, and treatment and outcome from the available literature, with the hopes of providing insight into treatment options. We followed the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (P...
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
IN THIS issue of the Journal of Cardiothoracic and Vascular Anesthesia, Villablanca et al. evaluated whether the presence and diagnosis of a patent foramen ovale (PFO) or atrial septal defect (ASD) preoperatively was associated with an increase in perioperative stroke for patients undergoing noncardiac surgery.1 The authors used “big data” to describe the largest study to date of 19,659,191 hospitalizations retrieved from the Healthcare Cost and Utilization Project's National Readmission Database.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
Authors: Ntaios G, Tzikas A, Vavouranakis E, Nikas D, Katsimagklis G, Koroboki E, Manolis AS, Milionis H, Papadopoulos K, Sideris S, Spengos K, Toutouzas K, Tziakas D, Vassilopoulou S, Kanakakis I, Vemmos K, Tsioufis K Abstract Patent foramen ovale (PFO) is a frequent echocardiographic finding and can be found in approximately 15-25% of the general population1 (Figure 1). The incidence of PFO is 2- to 3-fold higher in patients with stroke of undetermined etiology compared to the general population, a finding that implies a causative role of PFO in patients with stroke of undetermined etiology 2,3. In this context, ...
Source: Hellenic Journal of Cardiology - Category: Cardiology Tags: Hellenic J Cardiol Source Type: research
Conclusions: Stroke management is based on evaluation of individual patient-risk factors. Evaluation and treatment is ideally directed by a vascular neurologist to ensure optimal secondary prevention, especially in cases where an underlying etiology is not identified on initial workup.
Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research
To evaluate whether a preoperative diagnosis of atrial septal defect (ASD) or patent foramen ovale (PFO) is associated with perioperative stroke in noncardiac surgery and their outcomes.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Conclusions: Stroke management is based on evaluation of individual patient-risk factors. Evaluation and treatment is ideally directed by a vascular neurologist to ensure optimal secondary prevention, especially in cases where an underlying etiology is not identified on initial workup.
Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research
Conditions:   Cryptogenic Stroke;   High Risk Patent Foramen Ovale Intervention:   Procedure: Percutaneous device closure Sponsors:   Asan Medical Center;   Medtronic Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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