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Updated: Jul 5, 2025
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Patent Foramen Ovale Percutaneous Closure: Evolution and Ongoing Challenges
Perrine Devos1, Paul Guedeney1, Gilles Montalescot1,2
1ACTION Study Group, INSERM UMRS_1166 Institut de Cardiologie (AP-HP), Sorbonne Université, 75005 Paris, France.
Insights
Patent foramen ovale (PFO) closure effectively reduces recurrent embolic events in cryptogenic stroke patients. This review explores current PFO closure indications, challenges, and future directions for related conditions.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Patent foramen ovale (PFO) affects nearly 25% of the population, rising to 50% in cryptogenic stroke cases.
- PFO is implicated in cryptogenic stroke, migraine, decompression sickness, and platypnea-orthodeoxia syndrome.
Purpose of the Study:
- To review current indications for percutaneous patent foramen ovale closure.
- To discuss challenges and future directions for PFO closure techniques and patient selection.
Main Methods:
- Review of recent randomized clinical trials on PFO closure.
- Analysis of evidence for PFO closure in various pathogenic conditions.
Main Results:
- Percutaneous PFO closure is confirmed to reduce recurrent embolic events in PFO-related stroke.
- Evidence for PFO closure in conditions beyond stroke is less established due to patient heterogeneity.
Conclusions:
- Percutaneous PFO closure is a validated treatment for cryptogenic stroke prevention.
- Further research is needed to clarify indications and optimize techniques for PFO closure in other conditions.
Abstract:
Patent foramen ovale (PFO) concerns nearly a quarter of the general population and incidence may reach up to 50% in patients with cryptogenic stroke. Recent randomized clinical trials confirmed that percutaneous closure of PFO-related stroke reduces the risk of embolic event recurrence. PFO also comes into play in other pathogenic conditions, such as migraine, decompression sickness or platypnea-orthodeoxia syndrome, where the heterogeneity of patients is high and evidence for closure is less well-documented. In this review, we describe the current indications for PFO percutaneous closure and the remaining challenges, and try to provide future directions regarding the technique and its indications.
