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February 2, 2026Stroke

Abstract DP261: Challenging the Age Barrier: Patent Foramen Ovale Closure in Patients Over 60 With Embolic Stroke of Undetermined Source and Cryptogenic Stroke Shows Favorable Outcomes

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Why the study?

PFO closure is recommended for patients younger than 60 years with ESUS or cryptogenic stroke, but its role in patients older than 60 years remains unclear.

Does patent foramen ovale (PFO) closure reduce recurrent ischemic stroke in patients older than 60 years with embolic stroke of undetermined source (ESUS) or cryptogenic stroke?

Population

Patients older than 60 years with ESUS or cryptogenic stroke from several large tertiary hospitals

Comparison

PFO closure vs age-matched control cohort

Design

Multicenter cohort study

Follow-up

Median 5 years

Key result

In patients older than 60, PFO closure showed a lower incidence of recurrent ischemic stroke (3.9%) compared to controls (8.2%) after 5 years, with 1% complication rate.

Authors

NANaser Haj AissaWZWansi ZHONGDMDania Mallick

Discussion

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Overview

PFO closure may be safe in select patients over 60; leaves open efficacy for recurrent stroke prevention pending randomized trials.

Key Points

  • The aim is to evaluate the effectiveness of patent foramen ovale closure in patients over 60 years with embolic or cryptogenic strokes.
  • Participants over 60 years with ESUS or cryptogenic stroke were selected from large hospitals.
  • Patients received PFO closure after a multidisciplinary conference.
  • Outcomes measured included recurrent ischemic strokes and complications, including atrial fibrillation.
  • PFO closure led to a low rate of recurrent ischemic stroke (3.9%).
  • Control group had a higher rate of stroke recurrency (8.2%).
  • Complications after PFO closure were minimal, reported at 1%.

Structured PICO

Does patent foramen ovale (PFO) closure reduce recurrent ischemic stroke in patients older than 60 years with embolic stroke of undetermined source (ESUS) or cryptogenic stroke?

P
Population
199 patients older than 60 years with embolic stroke of undetermined source (ESUS) or cryptogenic stroke from several large tertiary hospitals.
I
Intervention
Patent foramen ovale (PFO) closure
C
Comparator
Age-matched cohort patients with ESUS or cryptogenic stroke
O
Outcome
Recurrent ischemic stroke up to a median follow up of 5 yearshard clinical

In patients over 60 with cryptogenic stroke or ESUS, PFO closure is safe and demonstrates a non-significant trend toward reducing recurrent ischemic stroke compared to age-matched controls.

Cite This Study

Aissa et al. (2026) studied this question. In patients older than 60, PFO closure showed a lower incidence of recurrent ischemic stroke (3.9%) compared to controls (8.2%) after 5 years, with 1% complication rate.

synapsesocial.com/papers/6980fd60c1c9540dea80f15dhttps://doi.org/10.1161/str.57.suppl_1.dp261
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