Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke
Abstract Background Patent foramen ovale closure in the setting of stroke was debatable until the recent data from the long-term follow-up of multiple randomized control trials. These recent data have led to increase the number of the procedure worldwide. To our knowledge, there was no previous form...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-03-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-021-00139-8 |
| _version_ | 1818622178504998912 |
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| author | Amr Mansour Noha M. Gamal Azza A. Elfiky Mohamed Ayman Saleh Samia Ashour Mohamed Hala Mahmoud ElKhawas Ahmed ElSadek Noha L. Dawood Maiy H. Elsayed |
| author_facet | Amr Mansour Noha M. Gamal Azza A. Elfiky Mohamed Ayman Saleh Samia Ashour Mohamed Hala Mahmoud ElKhawas Ahmed ElSadek Noha L. Dawood Maiy H. Elsayed |
| author_sort | Amr Mansour |
| collection | DOAJ |
| description | Abstract Background Patent foramen ovale closure in the setting of stroke was debatable until the recent data from the long-term follow-up of multiple randomized control trials. These recent data have led to increase the number of the procedure worldwide. To our knowledge, there was no previous formal structured program in Egypt between cardiologists and neurologists for investigation and management of patients with cryptogenic stroke. The first Egyptian-dedicated stroke team was created in two large tertiary centers with collaboration between cardiologists, dedicated cardiac imagers, and neurologists for investigation and management of patients with cryptogenic stroke. Results Sixty-three patients with cryptogenic stroke were identified from a total of 520 patients admitted to the stroke units between 2016 and 2019. Twenty-five patients had a proven PFO-related stroke. Three patients were referred for surgical closure, 19 patients underwent transcatheter PFO closure, and procedural success was met in 18 patients (94.7%). We did not experience any major procedure-related complication. Complete closure was achieved in 83.3% of patients at 6 months. One patient had a single attack TIA within the first 3 months after device closure; one patient had a device-related thrombosis; both were managed successfully. Conclusion Our initial experience in collaboration between cardiologist and neurologist with the establishment of a dedicated cryptogenic stroke team added significantly to the management of patients with stroke. The results of the first Egyptian cohort who underwent transcatheter PFO closure demonstrated procedural feasibility, safety, and efficacy with very low incidence of major complications. A nationwide program is needed to reduce the ischemic stroke disease burden and the risk of recurrence. |
| first_indexed | 2024-12-16T18:21:02Z |
| format | Article |
| id | doaj.art-d8b503bc12324f0487e7a7af5837b600 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-12-16T18:21:02Z |
| publishDate | 2021-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-d8b503bc12324f0487e7a7af5837b6002022-12-21T22:21:33ZengSpringerOpenThe Egyptian Heart Journal2090-911X2021-03-017311810.1186/s43044-021-00139-8Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related strokeAmr Mansour0Noha M. Gamal1Azza A. Elfiky2Mohamed Ayman Saleh3Samia Ashour Mohamed4Hala Mahmoud ElKhawas5Ahmed ElSadek6Noha L. Dawood7Maiy H. Elsayed8Cardiology Department, Ain Shams UniversityCardiology Department, Faculty of Medicine, Assuit University Hospital, Assiut UniversityCardiology Department, Ain Shams UniversityCardiology Department, Ain Shams UniversityNeurology Department, Ain Shams UniversityNeurology Department, Ain Shams UniversityNeurology Department, Ain Shams UniversityNeurology Department, Ain Shams UniversityCardiology Department, Ain Shams UniversityAbstract Background Patent foramen ovale closure in the setting of stroke was debatable until the recent data from the long-term follow-up of multiple randomized control trials. These recent data have led to increase the number of the procedure worldwide. To our knowledge, there was no previous formal structured program in Egypt between cardiologists and neurologists for investigation and management of patients with cryptogenic stroke. The first Egyptian-dedicated stroke team was created in two large tertiary centers with collaboration between cardiologists, dedicated cardiac imagers, and neurologists for investigation and management of patients with cryptogenic stroke. Results Sixty-three patients with cryptogenic stroke were identified from a total of 520 patients admitted to the stroke units between 2016 and 2019. Twenty-five patients had a proven PFO-related stroke. Three patients were referred for surgical closure, 19 patients underwent transcatheter PFO closure, and procedural success was met in 18 patients (94.7%). We did not experience any major procedure-related complication. Complete closure was achieved in 83.3% of patients at 6 months. One patient had a single attack TIA within the first 3 months after device closure; one patient had a device-related thrombosis; both were managed successfully. Conclusion Our initial experience in collaboration between cardiologist and neurologist with the establishment of a dedicated cryptogenic stroke team added significantly to the management of patients with stroke. The results of the first Egyptian cohort who underwent transcatheter PFO closure demonstrated procedural feasibility, safety, and efficacy with very low incidence of major complications. A nationwide program is needed to reduce the ischemic stroke disease burden and the risk of recurrence.https://doi.org/10.1186/s43044-021-00139-8Cryptogenic strokeTranscatheter PFO closurePFO-related strokeAtrial septal aneurysmFenestrated interatrial septum |
| spellingShingle | Amr Mansour Noha M. Gamal Azza A. Elfiky Mohamed Ayman Saleh Samia Ashour Mohamed Hala Mahmoud ElKhawas Ahmed ElSadek Noha L. Dawood Maiy H. Elsayed Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke The Egyptian Heart Journal Cryptogenic stroke Transcatheter PFO closure PFO-related stroke Atrial septal aneurysm Fenestrated interatrial septum |
| title | Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke |
| title_full | Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke |
| title_fullStr | Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke |
| title_full_unstemmed | Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke |
| title_short | Multidisciplinary assessment of patients with ischemic stroke, the structure of a stroke team, and first Egyptian experience in adults undergoing transcatheter PFO closure for PFO-related stroke |
| title_sort | multidisciplinary assessment of patients with ischemic stroke the structure of a stroke team and first egyptian experience in adults undergoing transcatheter pfo closure for pfo related stroke |
| topic | Cryptogenic stroke Transcatheter PFO closure PFO-related stroke Atrial septal aneurysm Fenestrated interatrial septum |
| url | https://doi.org/10.1186/s43044-021-00139-8 |
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