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Transcranial Doppler Screening for Patent Foramen Ovale Closure in Cryptogenic Strokes in Young: A Single Center Experience from South India
CONCLUSIONS: R-L shunt is common in cryptogenic ischemic strokes in young. TCD with bubble contrast study is a noninvasive and feasible bedside tool to detect them. Applying the ESUS criteria in these cryptogenic strokes with a positive TCD bubble contrast study can be then used for selecting patients for more invasive tests like TEE. High-risk PFOs picked up with TEE can be then considered for PFO closure for secondary stroke prevention. The history of Valsalva maneuver-like activity (such as lifting heavy weights or straining) at the time of stroke onset can be a clinical predictor for the presence of an R-L shunt. In ad...
Source: Journal of the Association of Physicians of India - June 25, 2023 Category: General Medicine Authors: Deepti Bal Atif Iqbal Ahmed Shaikh Murali Rayani Sanjith Aaron Viji Samuel Thompson John Jose Jesu Krupa Rohit Ninan Benjamin Joanne Lydia Rajkumar Appaswamy Thirumal Prabhakar Source Type: research

Diagnostic Value of Micro-Bubble Transcranial Doppler Combined with Contrast Transthoracic Echocardiography in Cryptogenic Stroke Patients with Patent Foramen Ovale
Conclusion: The combination of MB-TCD and cTTE can improve the sensitivity and specificity of PFO diagnosis in cryptogenic stroke patients. MB-TCD medium also had high sensitivity and specificity.
Source: Neurology India - August 30, 2022 Category: Neurology Authors: Jianping Lu Jinguo Li Huapin Huang Qinyong Ye Source Type: research

Prevalence of Patent Foramen Ovale in North Indian Cryptogenic Young Strokes
Conclusions: There is a high prevalence of RLS likely secondary to PFO in cryptogenic young strokes in north India. TCD with bubble contrast is an excellent bedside tool for the detection of RLS.
Source: Neurology India - July 1, 2022 Category: Neurology Authors: Dheeraj Khurana Gayathri Petluri Mukesh Kumar Ajay Bahl Ashok Kumar Jitender Gairolla Sudesh Prabhakar Source Type: research

Simultaneous Acute Pulmonary Thromboembolism and Stroke & #8211; A Management Dilemma
We report the case of a 52-year-old man with concurrent massive right middle cerebral artery AIS and acute PTE, who was successfully managed despite the contradictory guidelines to manage them simultaneously. The patient underwent decompression craniotomy followed by anticoagulant therapy. The current case report demonstrates that full-dose heparin, despite being relatively contraindicated in an AIS, can achieve a good outcome when given under close monitoring. The transesophageal echo with bubble contrast during the Valsalva maneuver demonstrated patent foramen ovale with a right to left shunt as a cause of AIS and PTE in this patient.
Source: Neurology India - October 30, 2021 Category: Neurology Authors: Sita Jayalakshmi Harsh Khandalia Sudhindra Vooturi PA Jiwani Subhash Kaul Source Type: research

Patent foramen ovale closure in India; Feasibility, challenges and mid-term outcomes
Indian Heart J. 2021 Sep-Oct;73(5):656-659. doi: 10.1016/j.ihj.2021.09.001. Epub 2021 Sep 6.ABSTRACTPatent foramen ovale closure (PFO) is an underutilized therapy, and our study explored the challenges and feasibility of PFO closure in the Indian setting. Eighty patients with Embolic Stroke of Undetermined Source (ESUS) were screened by transcranial Doppler (TCD) for PFO. Twenty-nine patients underwent successful closure. High-risk features of a long tunnel, inter-atrial septal aneurysm, and large defect were present in 31%, 28%, and 59%. Transcranial Doppler had a sensitivity and specificity of 78% and 53% (p = 0.02) to d...
Source: Indian Heart J - October 10, 2021 Category: Cardiology Authors: Viji S Thomson Sanjith Aaron Nathaniel Samson D Jesu Krupa A T Prabhakar John Jose Paul George Oommen K George George Joseph Bijesh Kumar Yadav Source Type: research

Transcatheter Patent Foramen Ovale Closure in a Child with Cryptogenic Ischemic Stroke
Source: Indian Journal of Pediatrics - February 10, 2020 Category: Pediatrics Source Type: research

Patent foramen ovale: Connecting dots from massive pulmonary embolism to acute ischemic stroke
Ka U Lio, Maruti Kumaran, Parth RaliLung India 2019 36(6):564-566
Source: Lung India - October 30, 2019 Category: Respiratory Medicine Authors: Ka U Lio Maruti Kumaran Parth Rali Source Type: research

Patent Foramen Ovale Closure Versus Medical Therapy for Cryptogenic Stroke: An Updated Systematic Review and Meta-Analysis
ConclusionPFO closure is associated with a significant reduction in the risk of stroke compared to medical management. However, it causes an increased risk of atrial fibrillation.
Source: Indian Heart Journal - October 22, 2019 Category: Cardiology Source Type: research

Study of transesophageal echocardiography in young patients (<40 years) with acute arterial ischemic stroke: A pilot study
ConclusionCardiac abnormalities on TEE and holter were detected in 42.5% of the young patients with idiopathic arterial stroke. TEE abnormality was noted in 33% (13/40), whereas AF on holter was seen in 14.8% (4/27) with normal TEE. Thus, probable cardioembolic stroke was responsible for acute ischemic stroke in 42.5% (17/40) of young patients in the absence of valvular heart disease, prosthetic valves, and persistent/permanent AF.
Source: Medical Journal Armed Forces India - October 16, 2018 Category: General Medicine Source Type: research

Simplified percutaneous closure of patent foramen ovale and atrial septal defect with use of plain fluoroscopy: Single operator experience in 110 consecutive patients.
CONCLUSION: Percutaneous placement of an Amplatzer occluder was safe and effective with use of local anesthesia and fluoroscopy alone. There were no recurrent strokes over >4 years. Migraine relief was reported by >80% of patients. PMID: 29455783 [PubMed - in process]
Source: Indian Heart J - January 1, 2018 Category: Cardiology Authors: Manolis AS, Koulouris S, Rouska E, Pyrros J Tags: Indian Heart J Source Type: research

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