Related Experiment Video
Updated: May 6, 2026
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Predictors of recurrent stroke after percutaneous closure of patent foramen ovale
Volker Rudolph1, Jahan Augustin, Thomas Hofmann
1University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany.
Insights
Cardiovascular risk factors increase stroke recurrence risk after patent foramen ovale closure in patients with presumed paradoxical embolic stroke. Managing these factors is crucial for long-term patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Patent foramen ovale (PFO) closure is a debated treatment for paradoxical embolic stroke.
- The influence of cardiovascular risk factors (CVRF) on stroke recurrence post-PFO closure is not well understood.
Purpose of the Study:
- To investigate the impact of CVRF on long-term stroke/transient ischemic attack (TIA) recurrence after PFO closure.
- To identify predictors of recurrent cerebrovascular events in patients with PFO.
Main Methods:
- A cohort of 443 patients undergoing percutaneous PFO closure for presumed paradoxical embolic stroke was followed.
- Median follow-up was 43.0 months, with assessment of recurrent stroke/TIA and mortality.
- Cox regression analysis was used to identify risk predictors.
Main Results:
- 22 strokes/TIAs (5.0%) and 17 deaths (3.8%) were recorded during follow-up.
- Hypertension, older age, and higher Essen stroke risk score predicted recurrent stroke/TIA.
- PFO closure success was not explicitly detailed, but outcomes were linked to CVRF.
Conclusions:
- The risk of recurrent stroke/TIA after PFO closure in patients with presumed paradoxical embolic stroke is associated with the presence of CVRF.
- Effective management of CVRF is essential for reducing long-term risks in this patient population.
Aims:
Closure of patent foramen ovale following presumed paradoxical embolic stroke remains controversial. The answer to the question as to whether cardiovascular risk factors (CVRF) impact on the recurrence of stroke in patients who have undergone PFO closure remains elusive so far. We aimed to investigate the potential impact of CVRF on the long-term rate of stroke/TIA recurrence in patients treated with an occluder following presumed paradoxical embolic stroke.
Methods And Results:
443 patients (mean age: 50.0±12.6 yrs, female: 206 [46.5%]) undergoing percutaneous PFO closure after presumed paradoxical embolic stroke were followed for a median time of 43.0 [interquartile range: 20.0-86.0] months. During the follow-up period a total of 22 (5.0%) strokes/TIAs and 17 (3.8%) deaths were observed. Cox regression analysis identified hypertension, age and the Essen stroke risk score as predictors of recurrent stroke/TIA.
Conclusions:
This study shows that, in patients with a prior presumed paradoxical embolic stroke, the risk for recurrent stroke/TIA after PFO closure is firmly linked to the presence of CVRF.
