Key result
Closure of patent foramen ovale, especially when associated with an atrial septal aneurysm or large interatrial shunt, may reduce the risk of recurrent stroke compared to medical treatment.
Why the study?
It remains challenging to risk stratify patients with suspected PFO-related stroke and to decide if device closure is indicated.
Does device closure of PFO reduce recurrent stroke in patients with PFO and cryptogenic stroke?
Does device closure of PFO reduce recurrent stroke in patients with PFO and cryptogenic stroke?
PFO closure, particularly in patients with high-risk anatomical features like atrial septal aneurysm or large shunt, may reduce recurrent stroke risk compared to medical therapy in patients with cryptogenic stroke.
Answers are grounded in this paper and cite their sources.
Supports individualized PFO evaluation in cryptogenic stroke; leaves open validation of closure criteria in prospective cohorts.
Patent foramen ovale (PFO) is a common benign finding in healthy subjects, but its prevalence is higher in patients with stroke of unclear cause (cryptogenic stroke). PFO is believed to be associated with stroke through paradoxical embolism, and certain clinical and anatomical criteria seem to increase the likelihood of a PFO to be pathological. Recent trials have shown that closure of PFO, especially if associated with an atrial septal aneurysm and/or a large interatrial shunt, may reduce the risk of recurrent stroke as compared to medical treatment. However, it remains challenging to risk stratify patients with suspected PFO-related stroke and to decide if device closure is indicated. We sought to review contemporary evidence and to conclude an evidence-based strategy to prevent recurrence of PFO-related stroke.
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Abdelghani et al. (2019) conducted a review in Patent Foramen Ovale and Cryptogenic Stroke. Patent foramen ovale (PFO) closure vs. Medical treatment was evaluated on Recurrent stroke. Closure of patent foramen ovale, especially when associated with an atrial septal aneurysm or large interatrial shunt, may reduce the risk of recurrent stroke compared to medical treatment.
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