Size of PFO and amount of microembolic signals in patients with ischemic stroke or TIA
Department of Neurology, Echocardiography Laboratory, Rambam Health Care Campus and Technion Faculty of Medicine, Haifa, Israel. European Journal of Neurology
(Impact Factor: 4.06).
09/2008; 15(9):969-72. DOI: 10.1111/j.1468-1331.2008.02232.x
The inter-relation between the size of patent foramen ovale (PFO) by transesophageal echocardiography (TEE) and the amount of microembolic signals (MES) on transcranial doppler (TCD) is still not determined.
The study group comprised of 104 patients with first-ever ischaemic stroke or transient ischemic attack (TIA). Three groups were formed according to the amount of MES on TCD: a small amount of MES (0-10 MES); a moderate amount of MES (countable MES higher than 10); and multiple MES.
According to TEE, there were 52 patients (50%) with a small PFO, 37 patients (35.6%) with a moderate PFO, and 15 patients (14.4%) with a large PFO. There were 48 patients (46.1%) with a small amount of MES, 34 patients (32.7%) with a moderate amount of MES, and 22 patients (21.1%) with multiple MES on TCD. A strong relationship between the size of the PFO on TEE and the amount of MES on contrast transcranial Doppler was found (P < 0.0001), such that the larger the PFO on TEE, the greater the amount of MES on TCD.
There is a high correlation between the size of the PFO on TEE and the amount of MES on TCD in stroke and TIA patients.
Available from: Maria Lukasik
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ABSTRACT: In the first part of the paper we discuss the association between patent foramen ovale (PFO) and cryptogenic stroke. Patent foramen ovale is a remnant of the fetal circulation, found in about quarter of the general population. According to many authors, this common anatomical anomaly is of no or limited clinical significance. However, the results of some clinical studies suggest higher prevalence of PFO among subjects with either cryptogenic stroke or migraine with aura. To date, the answer to the question whether PFO is an independent risk factor for stroke remains equivocal. The purpose of this review is to discuss the role of PFO in pathophysiology of both symptomatic and asymptomatic ischaemic lesions and to analyze the coexisting factors that increase the risk of stroke. We also discuss the effectiveness of either pharmacological treatment or PFO closure in secondary stroke prevention.
Available from: Bernard Chan
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