title: [Thrombus attached to a Sideris septal occluder system 6 years later].
abstract: METHODS
  A 61-year-old man was admitted to hospital because of right-sided hypaesthesia. Additionally he reported a brief speech disturbance some weeks before. Neurological examination indicated right-sided sensomotoric hemiparesis and left-sided upper quadrant anopia. 6 years ago recurrent transient ischaemic attacks (TIA) was diagnosed caused by paradoxical embolism through a persistent foramen ovale (PFO). The PFO was closed with a 45 mm Sideris button occluder device. After this, he reported no symptoms of cerebral ischaemia and he did not take any antiplatelet therapy.
  
  
  METHODS
  Transesophageal echocardiography (TEE) showed a left atrial thrombus attached to the occluder. Cerebral computed tomography revealed infarction in regions supplied by the right posterior cerebral artery and left media cerebral artery. As additional risk factor for thrombosis a heterozygous factor V Leiden mutation was diagnosed.
  
  
  METHODS
  Multiple cerebral infarctions caused by a thrombus attached to an occluder system 6 years after interventional closure of persistent foramen ovale in a patient with heterozygous factor V Leiden mutation.
  
  
  METHODS
  The patient was anticoagulated (phenprocoumon) and the thrombus gradually dissolved.
  
  
  CONCLUSIONS
  A thrombosis on a Sideris occluder device may cause cerebral infarctions even years after transcatheter closure of a PFO.
authors.affiliation: Neurologische Klinik mit Poliklinik, Martin-Luther-Universität halle-Wittenberg, Halle/Salle. Charly.Gaul@gmx.de
authors.forename: C
authors.initials: C
authors.lastname: Gaul
authors.forename: J G
authors.initials: JG
authors.lastname: Heckmann
authors.forename: J
authors.initials: J
authors.lastname: Bremer
authors.forename: G
authors.initials: G
authors.lastname: Wasmeier
authors.forename: W J
authors.initials: WJ
authors.lastname: Huk
authors.forename: R
authors.initials: R
authors.lastname: Schräder
authors.forename: B
authors.initials: B
authors.lastname: Neundörfer
authors.forename: U
authors.initials: U
authors.lastname: Nixdorff
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000150:complications / Q000209:etiology; D005165:Factor V / Q000235:genetics; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000627:therapeutic use; D019736:Prostheses and Implants / Q000009:adverse effects*; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; D010644:Phenprocoumon