Five Year Follow-Up of Cryptogenic Stroke Patients Following Patent Foramen Ovale Closure

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dc.contributor.authorTeivāne, Agnete
dc.contributor.authorJurjāns, Kristaps
dc.contributor.authorRudzītis, Ainārs
dc.contributor.authorLazdovska, Krista
dc.contributor.authorBalodis, Artūrs
dc.contributor.authorMiglāne, Evija
dc.contributor.institutionRīga Stradiņš University
dc.contributor.institutionRed Cross Medical College of Rīga Stradiņš University
dc.contributor.institutionDepartment of Neurology and Neurosurgery
dc.date.accessioned2021-12-09T14:35:01Z
dc.date.available2021-12-09T14:35:01Z
dc.date.issued2021-06-21
dc.description.abstractAccording to guidelines, patent foramen ovale (PFO) closure is recommended for secondary stroke prevention in patients with cryptogenic stroke. Paradoxial embolism from PFO-mediated right to left shunt has been described as the mechanism of stroke in these cases. The aim of the study was to determine whether PFO closure can be associated with improvement of complaints (headaches, fatigue, heart palpitations, dizziness, and visual impairment) and determine its long-term effectiveness on recurrent stroke risk reduction. Materials and Methods: A total of 103 patients were enrolled in a retrospective study and followed-up by phone up to five years after PFO closure. Standardized survey was conducted about their well-being, recurrent cerebrovascular events, and the use of prescribed medication. Patients were also followed up for residual shunts 24 h, 30 days, 1 year, and 2 years after PFO. The pathogenic ischemic stroke subtypes are determined using CCS (Causative Classification System for Ischemic Stroke). Results: Male patients accounted for 43.7% (n = 45). The mean age was—44.4 ± 13 (18–75). The most probable cause for cryptogenic stroke for 53.4% (n = 55) of patients with possible cardio-aortic embolism was PFO. Residual shunts were mostly observed in patients with Amplatzer occluder—87.5% (n = 14). There was correlation between residual shunt and increased risk of transient ischemic attack recurrence (p = 0.067). Five-years after PFO closure recurrent cerebrovascular events were reported in only 5.1% (n = 5) of patients, this difference is statistically relevant (p < 0.001). Out of 51 patients presented with complaints before PFO closure, 25.5% (n = 13) did not present with any complaints after PFO closure. Conclusions: PFO can be considered a possible risk factor for cryptogenic stroke. PFO closure is effective in reducing recurrent cerebrovascular events. Residual shunt after PFO closure increases the risk of transient ischemic attack recurrence. Amplatzer occluder device is associated with a higher risk for residual shunts after PFO closure. PFO closure can be associated with improvement of complaintsen
dc.description.statusPeer reviewed
dc.format.extent1028670
dc.identifier.citationTeivāne, A, Jurjāns, K, Rudzītis, A, Lazdovska, K, Balodis, A & Miglāne, E 2021, 'Five Year Follow-Up of Cryptogenic Stroke Patients Following Patent Foramen Ovale Closure', Medical Sciences Forum, vol. 6, no. 1, pp. 1-10. https://doi.org/10.3390/iecmd2021-10313
dc.identifier.doi10.3390/iecmd2021-10313
dc.identifier.issn2673-9992
dc.identifier.otherunpaywall: 10.3390/iecmd2021-10313
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/7008
dc.language.isoeng
dc.relation.ispartofMedical Sciences Forum
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectpatent foramen ovale
dc.subjectpatent foramen ovale closure
dc.subjectcryptogenic stroke
dc.subjectparadoxical embolism
dc.subjectrecurrent stroke
dc.subject; secondary stroke prevention
dc.subject3.2 Clinical medicine
dc.subject1.4. Reviewed scientific article published in Latvia or abroad in a scientific journal with an editorial board (including university editions)
dc.titleFive Year Follow-Up of Cryptogenic Stroke Patients Following Patent Foramen Ovale Closureen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/conferencearticle

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