title: Factors related to recurrence of paradoxical cerebral embolism due to patent foramen ovale.
abstract: Patent foramen ovale (PFO) is an important etiology of ischemic stroke in young adults. We investigated factors contributing to recurrent ischemic stroke in patients with PFO. Subjects comprised 47 patients (mean age, 56.8 ± 14.2 years; range 23-74 years) with ischemic stroke due to PFO who were admitted to our hospital between April 2007 and February 2011. Mean duration of follow-up was 34.5 ± 13 months. Recurrence occurred in 11 cases. Annual recurrence rate was 23.4%. We investigated relationships between recurrence of ischemic stroke and size of PFO (large, >4 mm; medium, 2-3.9 mm; small, <1.9 mm; absent group), maximal number of microbubbles (determined as the number of microembolic signals: small, 0-5; moderate, 6-25; and multiple, ≥ 26), massive bubble on contrast transesophageal echocardiography or atrial septal aneurysm, D-dimer level and antithrombotic therapy. Univariate analysis showed size of the PFO (P = 0.013), number of microbubbles (P = 0.021), and presence of a massive bubble on echocardiography (P = 0.04) were related to recurrence of ischemic stroke. Logistic analysis identified size of the PFO (P < 0.05) and massive bubble on echocardiography (P < 0.05) as factors related to recurrence of ischemic stroke. In conclusion, size of the PFO and presence of a massive bubble were considered to be factors associated with recurrence of ischemic stroke due to PFO.
authors: Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan. tfukuoka@saiama-med.ac.jp
authors: Takuya
authors: T
authors: Fukuoka
authors: Tomohisa
authors: T
authors: Dembo
authors: Harumitu
authors: H
authors: Nagoya
authors: Yuji
authors: Y
authors: Kato
authors: Ohe
authors: O
authors: Yasuko
authors: Ichiro
authors: I
authors: Deguchi
authors: Hajime
authors: H
authors: Maruyama
authors: Yohsuke
authors: Y
authors: Horiuchi
authors: Hidetaka
authors: H
authors: Takeda
authors: Norio
authors: N
authors: Tanahashi
mesh_terms: D000328:Adult; D000368:Aged; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult