May-Thurner syndrome in patients with cryptogenic stroke and patent foramen ovale: an important clinical association.
May-Thurner syndrome in patients with cryptogenic stroke and patent foramen ovale: an important clinical association.
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DOI：
10.1161/strokeaha.108.527366
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发表时间：
2009-04
期刊：
影响因子：
8.3
通讯作者：
Palacios IF
中科院分区：
文献类型：
--
作者：
Kiernan TJ;Yan BP;Cubeddu RJ;Rengifo-Moreno P;Gupta V;Inglessis I;Ning M;Demirjian ZN;Jaff MR;Buonanno FS;Schainfeld RM;Palacios IF
我们的目的是调查卵圆孔未闭 (PFO) 的隐源性卒中患者中 May-Thurner 综合征 (MTS) 的发病率。这是一项回顾性研究。本研究纳入了2002年1月1日至2007年12月31日期间在我院连续接受PFO封堵术的隐源性脑卒中患者。对所有患者的盆腔磁共振静脉造影 (MRV) 研究进行回顾，以确定是否存在 MTS 特征。如果有的话，对所有患者的医疗记录和侵入性静脉造影研究进行审查。 MRV 上具有 MTS 特征的所有患者均由血管医学专家进行审查，以确定既往 DVT 的发生率或慢性静脉功能不全的任何体征。所有患者还进行了下肢静脉双重检查，以排除下肢静脉血栓形成。从2002年1月1日至2007年12月31日，共有470名隐源性中风患者在我们研究所接受了PFO封堵术。 30 名患者 (6.3%) 的特征与 MRV 上的 MTS 一致。这些患者主要为女性 (80%)，平均年龄为 43.6 ± 11.9 岁。 12 名患者 (40%) 在实验室血栓形成倾向评估中出现异常，13 名女性 (54.1%) 正在服用激素相关的避孕药。只有两名患者有慢性静脉功能不全的病史和体征。所有 PFO 经食管超声心动图均显示从右向左分流。 70% 的 MTS 患者存在房间隔动脉瘤/房间隔过度活动。 May-Thurner 综合征与隐源性中风和 PFO 具有重要的临床关联。
We aimed to investigate the incidence of May-Thurner syndrome (MTS) in cryptogenic stroke patients with patent foramen ovale (PFO). This was a retrospective study. All consecutive patients with cryptogenic stroke having undergone PFO closure from January 1st 2002 to December 31st 2007 at our institute were included in this study. Pelvic magnetic resonance venography (MRV) studies of all patients were reviewed to determine if features of MTS were present. Medical records and invasive venography studies of all patients were reviewed when available. All patients with MTS features on MRV were reviewed by a vascular medicine specialist to define any previous incidence of DVT or any signs of chronic venous insufficiency. All patients also had lower limb venous duplex performed to rule out lower limb venous thrombosis. A total of 470 patients from January 1 2002 until Dec 31 2007 with cryptogenic stroke underwent PFO closure at our institute. Thirty patients (6.3%) had features consistent with MTS on MRV. 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 two patients had a history and signs of chronic venous insuffiency. All PFOs demonstrated right-to-left shunting on transesophageal echocardiography. Atrial septal aneurysms/hypermobile atrial septa were present in 70% of patients with MTS. May-Thurner syndrome has an important clinical association with cryptogenic stroke and PFO.