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Decrease in shunt volume in patients with cryptogenic stroke and patent foramen ovale

Authors :
Pabst Wolfgang
Stolz Erwin
Jauss Marek
Kaps Manfred
Tanislav Christian
Nedelmann Max
Grebe Mathias
Reichenberger Frank
Allendoerfer Jens
Source :
BMC Neurology, Vol 10, Iss 1, p 123 (2010)
Publication Year :
2010
Publisher :
BMC, 2010.

Abstract

Abstract Background In patients with patent foramen ovale (PFO) there is evidence supporting the hypothesis of a change in right-to-left shunt (RLS) over time. Proven, this could have implications for the care of patients with PFO and a history of stroke. The following study addressed this hypothesis in a cohort of patients with stroke and PFO. Methods The RLS volume assessed during hospitalisation for stroke (index event/T0) was compared with the RLS volume on follow-up (T1) (median time between T0 and T1 was 10 months). In 102 patients with a history of stroke and PFO the RLS volume was re-assessed on follow-up using contrast-enhanced transcranial Doppler/duplex (ce-TCD) ultrasound. A change in RLS volume was defined as a difference of ≥20 microembolic signals (MES) or no evidence of RLS during ce-TCD ultrasound on follow-up. Results There was evidence of a marked reduction in RLS volume in 31/102 patients; in 14/31 patients a PFO was no longer detectable. An index event classified as cryptogenic stroke (P < 0.001; OD = 39.2, 95% confidence interval 6.0 to 258.2) and the time interval to the follow-up visit (P = 0.03) were independently associated with a change in RLS volume over time. Conclusions RLS volume across a PFO decreases over time, especially in patients with cryptogenic stroke. These may determine the development of new strategies for the management in the secondary stroke prevention.

Details

Language :
English
ISSN :
14712377
Volume :
10
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Neurology
Publication Type :
Academic Journal
Accession number :
edsdoj.5b1c394c235643ffb285de6d5e6f857f
Document Type :
article
Full Text :
https://doi.org/10.1186/1471-2377-10-123