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Related Experiment Video

Updated: Dec 23, 2025

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Patent foramen ovale.

Vafa Alakbarzade1, Tracey Keteepe-Arachi2, Nazia Karsan2

  • 1Neurology, Royal Cornwall Hospitals NHS Trust, Truro, UK vafa.alakbarzade.10@ucl.ac.uk.

Practical Neurology
|April 18, 2020
PubMed
Summary
This summary is machine-generated.

Patent foramen ovale (PFO) closure can reduce recurrent stroke risk in select younger patients with cryptogenic strokes. This intervention, combined with antiplatelet therapy, shows benefit over antiplatelet therapy alone for these specific individuals.

Keywords:
cardiologycerebrovascular diseaseinterventionalmigrainestroke

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Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Patent foramen ovale (PFO) is a common heart defect causing an interatrial shunt.
  • PFO can lead to paradoxical embolism, resulting in stroke, myocardial infarction, or ischemia.
  • PFO is a recognized risk factor for stroke and may be linked to migraine with aura.

Purpose of the Study:

  • To evaluate the efficacy of percutaneous PFO closure in preventing recurrent ischemic stroke.
  • To identify specific patient subgroups who benefit from PFO closure.
  • To compare PFO closure plus antiplatelet therapy versus antiplatelet therapy alone.

Main Methods:

  • Analysis of new evidence on PFO closure in stroke survivors.
  • Focus on a highly selected population: patients ≤60 years with cryptogenic stroke, large right-to-left shunt, atrial septal aneurysm, and no atrial fibrillation.
  • Comparison of outcomes between percutaneous PFO closure plus antiplatelet therapy and antiplatelet therapy alone.

Main Results:

  • Percutaneous PFO closure, when added to antiplatelet therapy, reduces the risk of recurrent ischemic stroke in a carefully selected group of younger stroke survivors.
  • This benefit is observed in patients with specific criteria including cryptogenic stroke syndrome, large shunts, and atrial septal aneurysm.
  • Current evidence does not support PFO closure for migraine treatment.

Conclusions:

  • PFO closure is a beneficial adjunctive therapy for specific young stroke survivors to prevent recurrent ischemic events.
  • Patient selection is critical for successful PFO closure outcomes.
  • PFO closure is not indicated for migraine management based on current data.