| Title |
Management of right-to-left shunt in cryptogenic cerebrovascular disease: results from the observational Austrian paradoxical cerebral embolism trial (TACET) registry
|
|---|---|
| Published in |
Journal of Neurology, August 2012
|
| DOI | 10.1007/s00415-012-6629-9 |
| Pubmed ID | |
| Authors |
Susanna Horner, Kurt Niederkorn, Thomas Gattringer, Martin Furtner, Raffi Topakian, Wilfried Lang, Robert Maier, Andreas Gamillscheg, Franz Fazekas |
| Abstract |
Paradoxical embolism due to a patent foramen ovale (PFO) is a possible cause of ischemic stroke, particularly in young cryptogenic stroke patients. In most cases, however, it is difficult to establish a firm etiological association and the debate about management is ongoing. The Austrian Paradoxical Cerebral Embolism Trial was designed as a prospective, national, multi-center, non-randomized registry to add further data on this topic before the completion of randomized controlled trials. Over 27 months 188 cryptogenic stroke/TIA patients ≤55 years were entered by 15 Austrian stroke units. Contrast transesophageal echocardiography demonstrated a cardiac right-to-left shunt (RLS) in 176 patients; a pulmonary RLS was assumed in 10, and 2 showed both. Ninety-seven (55 %) patients with cardiac RLS underwent interventional treatment, and this was more likely for patients with stroke as index event, a symptomatic infarction on MRI and a large size of PFO. Over 2 years, recurrences occurred at a rate of approximately 1.3 % for stroke and 4.3 % for TIA, and were especially frequent in patients with pulmonary RLS. When comparing outcomes in patients with cardiac RLS there was a trend for fewer recurrences with interventional management (closure: four TIA in four patients vs. medical: three strokes and seven TIA in nine patients; p = 0.066 for events, p = 0.085 for patients). The complication rate was 13.4, and 5.7 % had residual shunting. The possible causes for paradoxical embolism in young patients with cryptogenic stroke appear more variable than usually considered, and other causes than PFO should not be neglected. Interventional treatment of a cardiac RLS may offer a small benefit, but has to be weighed against possible complications and the problem of establishing causality. |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 15% |
| Researcher | 4 | 12% |
| Student > Postgraduate | 4 | 12% |
| Student > Master | 4 | 12% |
| Student > Ph. D. Student | 3 | 9% |
| Other | 7 | 21% |
| Unknown | 7 | 21% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 59% |
| Linguistics | 1 | 3% |
| Neuroscience | 1 | 3% |
| Sports and Recreations | 1 | 3% |
| Unknown | 11 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 August 2012.
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#20,193,180
of 22,710,079 outputs
Outputs from Journal of Neurology
#3,962
of 4,454 outputs
Outputs of similar age
#147,898
of 165,051 outputs
Outputs of similar age from Journal of Neurology
#52
of 52 outputs
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