Boğaziçi Tıp Dergisi (Jun 2023)
Patent Foramen Ovale Management in Cryptogenic Stroke Patients: Real-Life Data Collection
Abstract
INTRODUCTION: Ischemic stroke is still an important cause of morbidity and mortality in our country and in the world despite the developments in its treatment in recent years. Stroke recurrence can be avoided by determining the cause of the stroke and planning an effective treatment. To underline the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification, it is important to define and follow undetected (cryptogenic) strokes. Patent foramen ovale (PFO) plays a role in 40–50% of the etiology of cryptogenic strokes. PASCAL study has been published on the course of action if PFO is detected. In this way, the anatomical features of the PFO as well as the clinical features of the patient are evaluated in terms of which treatment to be decided in the patients. METHODS: For this purpose, a retrospective evaluation of 42 patients who presented to our clinic with ischemic stroke/TIA and were later discovered to have PFO was assessed. The risk of paradoxical embolism score was determined by asking the patients about their age, smoking status, HT, DM, history of TIA /ischemic stroke, and cortical infarction. RESULTS: In 18 of the patients, it was observed that the decision to close the PFO had been made. These patients were in the possible or prob-able group in the PASCAL classification. Nine of our 11 patients who did not have PFO closure had medical follow-up with antiaggregant therapy and two of them had started oral anticoagulant therapy. The patients who started taking anticoagulants AF found on the rhythm holter assessment. In the short-term follow-up (3–6 months) of our patients, no new attack was observed in either treatment group. DISCUSSION AND CONCLUSION: When PFO is detected in patients presenting with ischemic stroke, long-term results are needed with close follow-up and a coordinated study with cardiology.
Keywords
