Patent Foramen Ovale Closure After Cryptogenic Stroke: Scoring Systems, Age Cut-Offs and Residual Uncertainty
DOI:
https://doi.org/10.5281/zenodo.22365951Abstract
A patent foramen ovale is found in roughly a quarter of the general population, and in a substantially higher proportion of
patients with cryptogenic stroke -- a fact that has long made it difficult to know, for any individual patient, whether their PFO
caused the stroke or was simply present alongside it. Three large randomized trials over the past decade have clarified the
therapeutic question -- does closing the PFO reduce recurrence -- but the patient-selection question has proven at least as
consequential as the trial results themselves.
References
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Mas JL, Derumeaux G, Guillon B, et al. "Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke" (CLOSE). N Engl J Med 377(2017):1011-1021.
Sondergaard L, Kasner SE, Rhodes JF, et al. "Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke" (REDUCE). N Engl J Med 377(2017):1033-1042.
Messe SR, Kasner SE, Cucchiara BL, et al. "Practice advisory update summary: Patent foramen ovale and secondary stroke prevention". Neurology 94(2020):876-885.
Kent DM, Ruthazer R, Weimar C, et al. "An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke" (RoPE score). Neurology 81(2013):619-625.
