Why the study?
Does percutaneous PFO closure or anticoagulation prevent recurrent stroke in patients with cryptogenic stroke and PFO compared to medical therapy alone or antiplatelet therapy?
Population
Patients with cryptogenic ischemic stroke and patent foramen ovale (PFO)
Comparison
Percutaneous closure of PFO or anticoagulation vs Medical therapy alone or antiplatelet therapy
Design
Guideline
Authors
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May support AMPLATZER PFO closure for secondary stroke prevention in select patients; extends RCT evidence while underscoring AF risk.
Systematic Review
Does percutaneous PFO closure or anticoagulation prevent recurrent stroke in patients with cryptogenic stroke and PFO compared to medical therapy alone or antiplatelet therapy?
Effect estimate: RD -1.68% (95% CI -3.18% to -0.19%)
Routine percutaneous PFO closure is not recommended for patients with cryptogenic stroke outside of a research setting, though the AMPLATZER device may be considered in rare cases of recurrence despite adequate medical therapy.
Messé et al. (2016) conducted a systematic review in Stroke and patent foramen ovale (PFO). Percutaneous PFO closure vs. Medical therapy alone was evaluated on Recurrent stroke (RD -1.68%, 95% CI -3.18% to -0.19%). Percutaneous PFO closure with the AMPLATZER device possibly decreases recurrent stroke risk vs medical therapy (RD -1.68%; 95% CI -3.18% to -0.19%), but increases new-onset atrial fibrillation.
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