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Updated: Jun 29, 2026
10:52
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Cryptogenic stroke and patent foramen ovale.
David E Thaler1, Jeffrey L Saver
1The Comprehensive Stroke Center, Tufts Medical Center, Boston, MA 02111, USA. dthaler@tuftsmedicalcenter.org
Current Opinion in Cardiology
|October 3, 2008
Summary
Patent foramen ovale (PFO) closure for stroke prevention remains debated. Identifying pathogenic PFOs and high-risk patients is crucial for effective secondary stroke prevention.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Patent foramen ovale (PFO) is common, but its role in cryptogenic stroke is controversial.
- Paradoxical embolism is often presumed, and optimal secondary prevention strategies are unclear.
Purpose of the Study:
- To review current controversies and findings regarding patent foramen ovale (PFO), stroke, and secondary prevention.
- To discuss risk factors, diagnostic challenges, and treatment options for PFO-related stroke.
Main Methods:
- Review of recent studies and clinical trial data comparing PFO closure devices with medical management.
- Analysis of risk factors, including atrial septal aneurysm, PFO size, shunting, and hypercoagulable states.
Main Results:
- Atrial septal aneurysm is a key risk factor for stroke in PFO patients.
- Superficial and pelvic veins are emerging as potential embolism sources.
- Comparative data on PFO closure devices and medical treatments are becoming available.
Conclusions:
- Need for better strategies to differentiate incidental from pathogenic PFOs in cryptogenic stroke.
- Ongoing randomized trials are essential to compare PFO closure devices with medical management.
- Trials aim to determine if device risks are outweighed by reduced recurrent vascular events.
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