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SHR Neuro Cancer Cardio Lipid Metab Microb
Kneihsl, M; Horner, S; Hatab, I; Schöngrundner, N; Kramer, D; Toth-Gayor, G; Grangl, G; Wünsch, G; Fandler-Höfler, S; Haidegger, M; Berger, N; Veeranki, S; Fischer, U; Enzinger, C; Gattringer, T.
Long-term risk of recurrent cerebrovascular events after patent foramen ovale closure: Results from a real-world stroke cohort.
Eur Stroke J. 2023; 8(4):1021-1029
Doi: 10.1177/23969873231197564
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Gattringer Thomas
- Kneihsl Markus
- Co-authors Med Uni Graz
- Berger Natalie
- Enzinger Christian
- Fandler-Höfler Simon
- Grangl Gernot
- Haidegger Melanie
- Hatab Isra
- Horner Susanna
- Toth-Gayor Gabor
- Wünsch Gerit
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- Abstract:
- INTRODUCTION: Patent foramen ovale (PFO)-closure is recommended for stroke prevention in selected patients with suspected PFO-associated stroke. However, studies on cerebrovascular event recurrence after PFO-closure are limited by relatively short follow-up periods and information on the underlying aetiology of recurrent events is scarce. PATIENTS AND METHODS: All consecutive patients with a cerebral ischaemic event and PFO-closure at the University Hospital Graz were prospectively identified from 2004 to 2021. Indication for PFO-closure was based on a neurological-cardiological PFO board decision. Patients underwent standardized clinical and echocardiographic follow-up 6 months after PFO-closure. Recurrent cerebrovascular events were assessed via electronical health records. RESULTS: PFO-closure was performed in 515 patients (median age: 49 years; Amplatzer PFO occluder: 42%). Over a median follow-up of 11 years (range: 2-18 years, 5141 total patient-years), recurrent ischaemic cerebrovascular events were observed in 34 patients (ischaemic stroke: n = 22, TIA: n = 12) and associated with age, hyperlipidaemia and smoking in multivariable analysis (p < 0.05 each). Large artery atherosclerosis and small vessel disease were the most frequent aetiologies of recurrent stroke/TIA (27% and 24% respectively), and only two events were related to atrial fibrillation (AF). Recurrent ischaemic cerebrovascular event rates and incident AF were comparable in patients treated with different PFO occluders (p > 0.1). DISCUSSION AND CONCLUSION: In this long-term follow-up-study of patients with a cerebral ischaemic event who had received PFO-closure with different devices, rates of recurrent stroke/TIA were low and largely related to large artery atherosclerosis and small vessel disease. Thorough vascular risk factor control seems crucial for secondary stroke prevention in patients treated for PFO-related stroke.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Middle Aged - administration & dosage
- Stroke - epidemiology
- Ischemic Attack, Transient - complications
- Brain Ischemia - epidemiology
- Foramen Ovale, Patent - complications
- Treatment Outcome - administration & dosage
- Cerebral Infarction - complications
- Atherosclerosis - epidemiology
- Find related publications in this database (Keywords)
- Cryptogenic stroke
- patent foramen ovale closure
- recurrent cerebrovascular events
- long-term follow-up