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Recurrent ischemic stroke/transient ischemic attack after patent foramen ovale closure: A cohort study
Henrik Sørensen1, Erik L Grove2,3, Johanne Andersen Hojbjerg3,4
1Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Summary
Patent foramen ovale (PFO) closure is recommended for stroke prevention, but recurrent events can occur. Hypertension and hypercoagulable states are linked to recurrent stroke/TIA after PFO closure.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Patent foramen ovale (PFO) is linked to ischemic stroke and transient ischemic attack (TIA).
- PFO closure is advised for stroke prevention, yet recurrent stroke risk persists.
- Understanding recurrent stroke causes and complications post-PFO closure is crucial.
Purpose of the Study:
- To investigate the causes of recurrent stroke/TIA after PFO closure.
- To evaluate post-interventional complications in patients undergoing PFO closure.
- To identify risk factors associated with recurrent ischemic events post-PFO closure.
Main Methods:
- Retrospective analysis of 310 patients undergoing PFO closure at Aarhus University Hospital (2018-2023).
- Data collection included demographics, risk factors, procedural details, complications, and recurrent stroke/TIA.
- Median follow-up of 2.6 years.
Main Results:
- Recurrent stroke/TIA occurred in 2.6% of patients (0.98 per 100 patient-years).
- Hypertension (50.0% vs. 16.9%) and hypercoagulable states (62.5%) were associated with recurrent events.
- New-onset atrial fibrillation occurred in 9.4% within 45 days, without subsequent ischemic events.
Conclusions:
- Recurrent ischemic stroke/TIA rates post-PFO closure align with prior studies.
- Pre-existing hypertension and hypercoagulable states are risk factors for recurrent events.
- PFO closure is a viable option, but risk factor management is essential.
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