Document Detail


May-Thurner syndrome in patients with cryptogenic stroke and patent foramen ovale: an important clinical association.
MedLine Citation:
PMID:  19182088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: We aimed to investigate the incidence of May-Thurner syndrome in patients with cryptogenic stroke with patent foramen ovale. METHODS: This was a retrospective study. All consecutive patients with cryptogenic stroke having undergone patent foramen ovale closure from January 1, 2002, to December 31, 2007, at our institute were included in this study. Pelvic magnetic resonance venography studies of all patients were reviewed to determine if features of May-Thurner syndrome were present. Medical records and invasive venography studies of all patients were reviewed when available. All patients with May-Thurner syndrome features on magnetic resonance venography were reviewed by a vascular medicine specialist to define any previous incidence of deep vein thrombosis or any signs of chronic venous insufficiency. All patients also had lower limb venous duplex performed to rule out lower limb venous thrombosis. RESULTS: A total of 470 patients from January 1, 2002, until December 31, 2007, with cryptogenic stroke underwent patent foramen ovale closure at our institute. Thirty patients (6.3%) had features consistent with May-Thurner syndrome on magnetic resonance venography. These patients were predominantly female (80%) with a mean age of 43.6+/-11.9 years. Twelve patients (40%) had abnormalities in their laboratory thrombophilia evaluation and 13 females (54.1%) were taking hormone-related birth control pills. Only 2 patients had a history and signs of chronic venous insufficiency. All patent foramen ovales demonstrated right-to-left shunting on transesophageal echocardiography. Atrial septal aneurysms/hypermobile atrial septa were present in 70% of patients with May-Thurner syndrome. CONCLUSIONS: May-Thurner syndrome has an important clinical association with cryptogenic stroke and patent foramen ovale.
Authors:
Thomas J Kiernan; Bryan P Yan; Roberto J Cubeddu; Pablo Rengifo-Moreno; Vishal Gupta; Ignacio Inglessis; MingMing Ning; Zareh N Demirjian; Michael R Jaff; Ferdinando S Buonanno; Robert M Schainfeld; Igor F Palacios
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-01-29
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-24     Revised Date:  2009-07-29    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1502-4     Citation Subset:  IM    
Affiliation:
Department of Interventional Cardiology and Vascular Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. tjkiernan@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Foramen Ovale, Patent / epidemiology*
Humans
Iliac Vein / pathology,  radiography
Incidence
Male
Middle Aged
Phlebography
Retrospective Studies
Risk Factors
Sex Distribution
Stroke / epidemiology*
Thrombophilia / epidemiology
Vascular Diseases / epidemiology*,  pathology,  radiography
Grant Support
ID/Acronym/Agency:
NS051588/NS/NINDS NIH HHS; NS052498/NS/NINDS NIH HHS
Comments/Corrections
Comment In:
Stroke. 2009 Aug;40(8):e530; author reply e531-e532   [PMID:  19542055 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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