TY - JOUR

T1 - The role of device closure of patent foramen ovale in patients with cryptogenic stroke

AU - Fukutomi, M.

AU - Wilkins, B.

AU - Søndergaard, L.

N1 - Publisher Copyright: © 2020 The Association for the Publication of the Journal of Internal Medicine

PY - 2020

Y1 - 2020

N2 - One of the most frequent causes of cardiac embolism in cryptogenic stroke is a paradoxical embolus, which originate from systemic venous source though an unidentified patent foramen ovale (PFO). PFO is a common finding in the general population with a prevalence of 25% to 30%. Transcatheter PFO device closure is known to be feasible and safety treatment for such patients. In recent years, several randomized controlled trials (RCTs) have been conducted to address the superiority of PFO closure over medical therapy alone in the prevention of stroke recurrence in patients with PFO. In contrast to findings from early 3 RCTs, recent 4 RCTs could successfully show the benefits of PFO device closure compared with medical therapy, with less peri- and postprocedural complication. Based on these data, PFO device closure is recommended to carefully select cryptogenic stroke patients aged from 18 to 65 years, with a high probability of a causal role of the PFO in stroke events. However, it is still uncertain whether PFO closure is superior to oral anticoagulants therapy in these patients. Therefore, further prospective randomized trials are needed to address the efficacy of PFO device closure to oral anticoagulants therapy.

AB - One of the most frequent causes of cardiac embolism in cryptogenic stroke is a paradoxical embolus, which originate from systemic venous source though an unidentified patent foramen ovale (PFO). PFO is a common finding in the general population with a prevalence of 25% to 30%. Transcatheter PFO device closure is known to be feasible and safety treatment for such patients. In recent years, several randomized controlled trials (RCTs) have been conducted to address the superiority of PFO closure over medical therapy alone in the prevention of stroke recurrence in patients with PFO. In contrast to findings from early 3 RCTs, recent 4 RCTs could successfully show the benefits of PFO device closure compared with medical therapy, with less peri- and postprocedural complication. Based on these data, PFO device closure is recommended to carefully select cryptogenic stroke patients aged from 18 to 65 years, with a high probability of a causal role of the PFO in stroke events. However, it is still uncertain whether PFO closure is superior to oral anticoagulants therapy in these patients. Therefore, further prospective randomized trials are needed to address the efficacy of PFO device closure to oral anticoagulants therapy.

KW - cryptogenic stroke

KW - persistent foramen ovale

KW - transcatheter device closure

UR - http://www.scopus.com/inward/record.url?scp=85089675939&partnerID=8YFLogxK

U2 - 10.1111/joim.13143

DO - 10.1111/joim.13143

M3 - Review

C2 - 32812297

AN - SCOPUS:85089675939

VL - 288

SP - 400

EP - 409

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0955-7873

IS - 4

ER -