Recurrent ischemic stroke/transient ischemic attack after patent foramen ovale closure: A cohort study

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Henrik Sørensen1, Erik L Grove2,3, Johanne Andersen Hojbjerg3,4

  • 1Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

International Journal of Stroke : Official Journal of the International Stroke Society
|August 23, 2024
PubMed

Insights

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.
Abstract

Keywords:
Acute strokepatent foramen ovalepreventionprognosisthrombophilia

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