PhD Scientific Days

Poster Presentation: Neurosciences

P52: The importance of patent foramen ovale and transcranial Doppler sonography in cryptogenic stroke

Előadó neve

TÖRÖLHETŐBöjti, Péter Pál

Előadó munkahelye

Department of Neurology, Medical Centre Hungarian Defence Forces

Előadó telefonszáma

+36307214745

Előadó e-mail címe

nuclaccumbens@gmail.com

Az előadás címe

The importance of patent foramen ovale and transcranial Doppler sonography in cryptogenic stroke

Szerző(k) neve és munkahelye

Péter Pál Böjti, MD1, Noémi Eszter Bartha2, Zoltán Szakács MD, Ph.D1, Géza Szilágyi, MD, Ph.D1
1 Department of Neurology, Medical Centre Hungarian Defence Forces, Budapest, Hungary; János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
2 Neurology Clinic II, Mureş County Clinical Emergency Hospital, University of Medicine and Pharmacy of Târgu Mureş, Târgu Mureş, Romania

Szekció

Poster Presentation: Neurosciences

Data of the presenter

Doctoral School: János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
Program: Clinical Neurosciences
Supervisor: Géza Szilágyi
E-mail address: nuclaccumbens@gmail.com

Text of the abstract

Introduction: After routine workup, 23-25% of ischemic strokes etiology remains cryptogenic. However, extended investigation reveals a pathogenic patent foramen ovale (PFO) in 20-25% of these cases. The gold standard for identifying a PFO is transesophageal echocardiography (TEE), but transcranial Doppler sonography (TCD) can be complementary because of its high sensitivity and simplicity.
Aim: We emphasize the importance of PFO and TCD in the diagnostic workup of cryptogenic strokes (CS).
Methods: All ischemic strokes that were treated in 2014 in our department were classified by ASCOD phenotyping. CS was defined when the etiology was unknown. We examined those CS patients who underwent TCD and consecutive TEE to reveal a PFO and with the help of RoPE (Risk of Paradoxical Embolism) score we determined and characterized PFO-related strokes.
Results: In 2014, 468 ischemic strokes were treated. Based on ASCOD 31% cardiac pathology, 25,2% small-vessel disease, 19,9% atherothrombosis, 1,5% dissection and 1,5% other known causes were defined. Evaluation was insufficient for categorization in 13,2%. In the remaining 36 cases (7,7%) CS was definable, of which 13 subjects underwent TCD and consecutive TEE that in 8 patients identified PFO. From these 8 subjects in 7 cases RoPE score was high (>5). Based on these in 7 cases (19%) PFO-related stroke could be diagnosed in the CS population. Characteristics of PFO-related stroke population: mean age is 36±9 year, mean RoPE score is 8, prevalence of hypertension and prior stroke/TIA are 7/2 and 7/1, diabetes mellitus and smoking are absent. After evaluation, secondary prevention involved percutaneous PFO-closure (7/5, 71,4%) or antithrombotic therapy (7/2, 28,6%).
Conclusion: 19% of CS patients were found to have PFO-related stroke. These patients are typically young, socially active, without vascular risk factors. TCD is proved to be useful technique during the diagnostic workup of CS. The assumption of PFO-pathogenicity was based on RoPE score.

Azonosító

P52

Kind

Szabad

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1223

PhD Scientific Days 2017

Budapest, 11-12 April 2017