Comprehensive review identifies gaps in antithrombotic therapy effects for embolism prevention post-PFO closure, suggesting further research is needed.
The patent foramen ovale (PFO), present in 25% of the population, can cause paradoxical embolism and stroke. Transcatheter PFO closure is the gold standard for recurrent embolism with significant inter‐atrial shunting, with recent trials confirming its superiority in reducing ischemic stroke recurrence over medical therapy. However, device‐related thrombosis remains a concern, posing risks of systemic embolism and neurological events. Optimal post‐closure antithrombotic management, including the choice and duration of therapy, remains unclear. Recommendations suggest transient dual antiplatelet therapy followed by long‐term single therapy, but robust evidence is lacking, especially regarding device neo‐endothelization timelines. Current studies often lack long‐term follow‐up, leaving gaps in understanding the incidence and prevention of thrombosis. Future research is crucial to provide evidence‐based guidance and refine personalized treatment strategies for better outcomes.
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Beneki et al. (2025) studied this question.
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