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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
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Patent Foramen Ovale and Stroke-Current Status
Oh Young Bang1, Mi Ji Lee1, Sookyung Ryoo1
1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Journal of Stroke
|October 7, 2015
Summary
Patent foramen ovale (PFO) closure shows no superiority over medical treatment for embolic stroke of undetermined source (ESUS). Alternative stroke mechanisms in PFO patients warrant further investigation.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Patent foramen ovale (PFO) is increasingly recognized in embolic stroke of undetermined source (ESUS).
- Advances in diagnosis and device closure have heightened clinical interest in PFO.
- Recent trials question the efficacy of PFO closure for ESUS.
Purpose of the Study:
- To review the current understanding of stroke pathophysiology in patients with PFO and ESUS.
- To explore therapeutic options for PFO-associated ESUS.
Main Methods:
- Literature review of recent randomized controlled trials.
- Analysis of PFO diagnosis and treatment advancements.
- Discussion of stroke mechanisms beyond paradoxical embolism.
Main Results:
- Randomized trials failed to show PFO closure superiority over medical management for ESUS.
- The role of paradoxical embolism as the sole stroke mechanism is debated.
- Alternative stroke etiologies are likely significant in ESUS patients with PFO.
Conclusions:
- PFO closure may not be superior to medical therapy for all ESUS patients.
- Understanding non-embolic stroke mechanisms in PFO patients is crucial.
- Further research is needed to refine therapeutic strategies for ESUS and PFO.
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