An Analysis Of Clinical Features And Prevetion Of Stroke Of The Ischemic Stroke Patients With Patent Foramen Ovale

Objective: To observe the clinical characteristics in ischemic stroke patients with patent foramen ovale.To compare the efficacy of transcatheter PFO closure and oral anti-platelet drugs in secondary prevention of stroke.Methods: We retrospectively studied a total number of 113 patients with ischemic stroke and PFO enrolled from March 2017 to March 2019 in our hospital.The patients were divided into ESUS group and non-ESUS group by the criteria of embolic stroke of undetermined source(ESUS).To determine the heterogeneity between two groups in order to explore other underlying etiologies.Follow-up assessments were performed 3 months,6 months,12 months after discharged,the effectiveness of transcatheter PFO closure and oral anti-platelet drugs were compared separately within two groups.Results:1.Other than hypertension and hyperlipidemia(P<0.05),there were no differences in between the two groups.2.The imageological features examination showed that the non-ESUS group had more intracranial non-responsible arteriosclerosis than the ESUS group with a statistical significance(P< 0.05).3.The clinical baseline characteristics between the surgery group and the drug group did not show any differences between the groups in clinical laboratory tests(P> 0.05).4.In all patients,the recurrence rate of stroke in the surgery group was lower than that in the drug group from 0-6 months,the differences were statistically significant(P< 0.05).5.The recurrence rate of surgical treatment within 1 year in the ESUS group(3.1%)was lower than that of drug treatment(19.4%),showing significant statistical difference(P< 0.05).6.Although the recurrence rate of surgical treatment within 1 year in the non-ESUS group(7.1%)was lower than that of drug treatment(13.0%),there was no significant difference between the two groups(P>0.05).7.The most common type of lesions with PFO in ischemic stroke was single lesion,accounting for about 45.8% of all lesion types.The second was multiple lesions of single circulation,accounting for 27.9% of the total.There was no significant correlation between RLS level and imaging features of lesions(P> 0.05).8.There was no significant correlation between RLS level and the severity of stroke(P> 0.05).9.There was an obvious(P> 0.05)linear relationship between age and the diameter of foramen ovale that the diameter of foramen ovale increased with age.Conclusions:1.In ischemic stroke patients with PFO,compared to the ESUS group,the non-ESUS group accompany with more history of hypertension and hyperlipidemia and more intracranial arteriosclerosis.2.For the secondary prevention of stroke in patients with ischemic stroke with PFO,surgical treatment is generally superior than drugs.3.In ischemic stroke patients with PFO,the imaging manifestations’ types of the lesion were mostly single cortical-subcortical lesion,followed by unilateral multiple lesion.4.In ischemic stroke patients with PFO,the diameter of foramen ovale increased with age.