Key result
Transcatheter patent foramen ovale closure and antithrombotic treatment remain controversial options for preventing recurrent ischemic stroke, highlighting the need for further randomized trials.
Why the study?
Does transcatheter PFO closure compared to medical treatment prevent recurrent ischemic stroke in patients with PFO?
Does transcatheter PFO closure compared to medical treatment prevent recurrent ischemic stroke in patients with PFO?
This review emphasizes the need for further randomized trials to determine the optimal strategy (PFO closure vs medical therapy) for preventing recurrent stroke in patients with PFO.
Answers are grounded in this paper and cite their sources.
PFO closure and antithrombotics should not yet change practice for recurrent stroke; leaves open optimal strategy pending definitive randomized trials.
PURPOSE OF REVIEW: The role of a patent foramen ovale (PFO) as a risk factor for ischemic stroke has been established in recent years. However, the best therapeutic option to prevent recurrent events is still controversial, with antithrombotic treatment or transcatheter PFO closure being favored by different clinicians. Also, associated conditions that may guide the therapeutic choices are being investigated. RECENT FINDINGS: The stroke risk associated with a PFO, mainly considered of importance in younger patients, has also been recognized and better defined in patients over the age of 55 years. The study of potential cofactors that may increase the possibility of paradoxical embolization through the PFO has made some progress and holds promises of allowing more informed and rational treatment choices in the future. More data have become available on the efficacy of transcatheter PFO closure. SUMMARY: The approach to patients with PFO and ischemic stroke has been better defined in recent years. However, a better understanding of factors that increase the stroke risk in individuals with a PFO and the results from randomized treatment trials comparing medical treatment with PFO closure are needed to further advance the field.
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Tullio et al. (2009) conducted a review in Patent foramen ovale and ischemic stroke. Transcatheter PFO closure vs. Antithrombotic treatment was evaluated. Transcatheter patent foramen ovale closure and antithrombotic treatment remain controversial options for preventing recurrent ischemic stroke, highlighting the need for further randomized trials.
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