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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Uncertainties and Controversies in the Management of Ischemic Stroke and Transient Ischemic Attack Patients With

Scott E Kasner1, Simona Lattanzi2, Ana Catarina Fonseca3

  • 1Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.E.K.).

Stroke
|October 27, 2021
PubMed

Insights

Patent foramen ovale closure benefits stroke patients, but questions remain regarding optimal patient selection, diagnosis, and treatment. This review clarifies current data and suggests future research directions for patent foramen ovale (PFO) stroke management.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Device Technology

Background:

  • Patent foramen ovale (PFO) closure shows benefit over medical therapy for cryptogenic stroke.
  • Significant uncertainties persist regarding patient selection, pathophysiology, diagnosis, and treatment strategies for PFO-related strokes.

Purpose of the Study:

  • To review and synthesize current data on PFO closure for stroke.
  • To address controversies and uncertainties in PFO stroke management.
  • To provide clinical clarity and future research directions.

Main Methods:

  • Systematic review of randomized clinical trials.
  • Analysis of data on patient selection, pathophysiology, diagnosis, and treatment.
  • Synthesis of existing literature.

Main Results:

  • Evidence supports PFO closure for specific stroke patient groups.
  • Key areas of controversy include optimal closure device selection and long-term outcomes.
  • Diagnostic criteria and patient stratification require further refinement.

Conclusions:

  • PFO closure is a valuable therapeutic option for select stroke patients.
  • Further research is needed to optimize patient selection and treatment protocols.
  • Standardized diagnostic and management guidelines are essential for PFO-related stroke.

Keywords:
cerebral embolismclinical trialembolic strokeforamen ovale

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