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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

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Patent foramen ovale and stroke: Should PFOs be closed in otherwise cryptogenic stroke?

David A Carpenter1, Andria L Ford, Jin-Moo Lee

  • 1Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA. carpenterd@wustl.edu

Current Atherosclerosis Reports
|May 13, 2010
PubMed

Insights

The link between patent foramen ovale (PFO) and ischemic stroke remains controversial. Current evidence does not support PFO as a cause of recurrent stroke, necessitating further trials on PFO closure effectiveness.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • The association between patent foramen ovale (PFO) and ischemic stroke has been debated since 1988.
  • While case-control studies suggest a link, population-based studies have not confirmed it.
  • Recurrent stroke risk in patients with cryptogenic stroke is not elevated by the presence of a PFO.

Purpose of the Study:

  • To evaluate the controversial association between PFO and ischemic stroke.
  • To assess the risk of recurrent stroke in patients with PFO.
  • To determine the necessity of ongoing randomized clinical trials for PFO closure.

Main Methods:

  • Review of case-control and population-based studies on PFO and ischemic stroke.
  • Analysis of studies examining recurrent stroke risk in patients with and without PFO.
  • Consideration of trends in percutaneous closure device utilization.

Main Results:

  • Case-control studies report an association, but population-based studies do not confirm it.
  • No increased risk of recurrent stroke was found in patients with PFO.
  • Percutaneous PFO closure device use has significantly increased.

Conclusions:

  • The link between PFO and ischemic stroke requires further investigation.
  • Evidence does not currently support PFO as a cause of recurrent stroke.
  • Randomized trials are crucial to ascertain the benefits versus risks of PFO closure.

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