The Role of Patent Foramen Ovale in Cryptogenic Stroke

Şenadım, Songül; Bozkurt, Dilek; Çabalar, Murat; Bajrami, Arsida; Yayla, Vildan

doi:10.5152/npa.2015.10034

Cited by 5 publications

(6 citation statements)

References 30 publications

(34 reference statements)

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“…Accumulated data support the notion that PFO is liable for in situ thrombus formation (13,(20)(21)(22). This hypothesis is empowered by the fact that specific features, such as long-tunneled PFO, concomitant presence of ASA or Chiari's network, increase the risk of stroke (1,(23)(24)(25). These findings do not favor the paradoxical embolism hypothesis, but the deceleration of flow, blood stagnation and thrombi formation within the PFO or ASA (20,26).…”

Section: In Situ Clot Formationmentioning

confidence: 97%

“…Usually, ASA is combined with PFO (60-89%), and when it does, PFO tends to be of larger size (20,40,49). Several other abnormalities have been correlated with ASA, such as atrial septal defects and mitral valve prolapse (24,33).…”

Section: Atrial Septal Aneurysmmentioning

confidence: 99%

“…ASA is associated with increased stroke risk, especially in the presence of PFO, and is considered a stronger risk factor than PFO (5,16,24,41,50,51). The incidence is even higher in younger patients and those with PFO-attributable stroke (16,52).…”

Section: Atrial Septal Aneurysmmentioning

confidence: 99%

“…Nevertheless, it is worth noting that PFO-attributable strokes do occur in older patients as well, although data are scarce and further investigation is needed ( 24 , 37 ). The population-based study of Mazzucco et al is in line with this statement, and suggests transcranial Doppler testing as a feasible and cost-effective screening ( 38 ).…”

Section: Agementioning

confidence: 99%

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Patent Foramen Ovale in Cryptogenic Ischemic Stroke: Direct Cause, Risk Factor, or Incidental Finding?

Ioannidis

Mitsias

2020

Front. Neurol.

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Patent foramen ovale (PFO) has been associated with cryptogenic stroke. There is conflicting data and it remains uncertain whether PFO is the direct cause, a risk factor or an incidental finding. Potential stroke mechanisms include paradoxical embolism from a venous clot which traverses the PFO, in situ clot formation within the PFO, and atrial arrhythmias due to electrical signaling disruption. Main risk factors linked with PFO-attributable strokes are young age, PFO size, right-to-left shunt degree, PFO morphology, presence of atrial septal aneurysm, intrinsic coagulation-anticoagulation systems imbalance, and coexistence of other atrial abnormalities, such as right atrial septal pouch, Eustachian valve and Chiari's network. These may act independently or synergistically, multiplying the risk of embolic events. The RoPE score, a scale that includes factors such as young age, cortical infarct location and absence of traditional stroke risk factors, is associated with the probability of a PFO being pathogenic and stroke recurrence risk after the index stroke. Multiple investigators have attempted to correlate other PFO features with the risk of PFO-related stroke, but further investigation is needed before any robust conclusions are reached. PFO presence in young patients with cryptogenic stroke should be considered as etiologically suspect. Caution should be exercised in interpreting the relevance of other PFO features.

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Section: In Situ Clot Formationmentioning

confidence: 97%

Section: Atrial Septal Aneurysmmentioning

confidence: 99%

Section: Atrial Septal Aneurysmmentioning

confidence: 99%

Section: Agementioning

confidence: 99%

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Patent Foramen Ovale in Cryptogenic Ischemic Stroke: Direct Cause, Risk Factor, or Incidental Finding?

Ioannidis

Mitsias

2020

Front. Neurol.

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“…Approximately 30% of ischemic strokes have no identifiable cause and are labeled as cryptogenic . A number of studies have suggested an association between patent foramen ovale (PFO), a frequent finding in the general population, and cryptogenic stroke . It has been postulated that the presence of a PFO can result in paradoxical embolism—a situation where an embolus from the venous system traverses from the right to left atrium and into the systemic circulation resulting in cerebrovascular events such as stroke .…”

Section: Introductionmentioning

confidence: 99%