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PFO Closure for Cryptogenic Stroke

Sabreena J Gillow1, Vivien H Lee

  • 1Department of Neurological Sciences, Section of Cerebrovascular Disease, Rush University Medical Center, 1725 W. Harrison St #1121, Chicago, IL, 60612, USA, Sabreena_J_Gillow@rush.edu.

Current Atherosclerosis Reports
|June 17, 2015
PubMed

Insights

Patent foramen ovale (PFO) is linked to cryptogenic stroke. While closure is common, few trials assess its effectiveness in preventing future ischemic events.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Patent foramen ovale (PFO) is a common cardiac anomaly.
  • PFO is a potential pathway for paradoxical embolism causing ischemic stroke.
  • The association between PFO and cryptogenic stroke remains debated, particularly in younger patients.

Purpose of the Study:

  • To review the current understanding of PFO as a mechanism for ischemic stroke.
  • To discuss the evolving treatment strategies for PFO, including closure interventions.
  • To highlight the limited evidence from randomized controlled trials on PFO closure efficacy for stroke prevention.

Main Methods:

  • Literature review of studies investigating PFO and stroke.
  • Analysis of traditional and contemporary treatment approaches for PFO.
  • Assessment of the existing randomized controlled trial data on PFO closure.

Main Results:

  • PFO is frequently found in the general population.
  • Antithrombotic therapy has been the traditional management for PFO-associated stroke risk.
  • Transcatheter and surgical PFO closure are increasingly used, but robust trial data is scarce.

Conclusions:

  • The role of PFO in cryptogenic stroke is still under investigation.
  • Further high-quality randomized controlled trials are needed to establish the efficacy of PFO closure for stroke prevention.
  • Evidence-based guidelines for PFO management in stroke patients require strengthening.

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