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The following is the summary of “Deep vein thrombosis in patients with stroke or transient ischemic attack presenting with patent foramen ovale: a retrospective observational study,” published in the August 2024 issue of Neurology by Huber et al.

Deep vein thrombosis (DVT) is a possible cause of brain ischemia in the presence of patent foramen ovale (PFO). However, different studies show varying DVT rates in patients with stroke, and screening guidance is also unclear. 

Researchers conducted a retrospective study focused on understanding patients with stroke or transient ischemic attack (TIA) who also have PFO, looking at how often they have DVT and examining related factors. 

They reviewed medical records of patients with stroke or TIA with PFO confirmed by echocardiography. Concomitant DVT was identified using compression ultrasound of the legs. The demographic, clinical, and lab data were compared, along with RoPE and Wells scores, between patients with and without DVT.

The results showed 339 patients (average age 61.2 years, 61.1% male) with stroke or TIA and PFO treated (January 2015 and December 2020), 17 out of 217 (7.8%) had DVT detected by ultrasound. The DVT was associated with past DVT, cancer, immobilization, calf compression pain, calf circumference difference, and laboratory issues like high D-dimer. The Wells score strongly predicted DVT (OR 35.46, 95% CI: 4.71-519.92). 

Investigators concluded that DVT was common in patients with cerebral ischemia and PFO, so it should be part of the diagnostic workup. The Wells score seemed to be a valuable tool for deciding if further tests like ultrasound are needed.

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03802-0