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Updated: Jul 23, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
The cryptogenic stroke patient's pathway and the qualification process for a patent foramen ovale closure:
Michał Borończyk1,2, Aleksandra Michalewska-Włudarczyk3, Julia Woźniak4
1Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland. mboronczyk@onet.pl.
Insights
Patent foramen ovale (PFO) closure is key for cryptogenic stroke (CS) prevention. Eligible patients show specific clinical profiles, guiding PFO closure decisions for secondary stroke prevention.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Nearly half of cryptogenic stroke (CS) patients have a patent foramen ovale (PFO).
- Percutaneous PFO closure is a proven secondary prevention strategy for CS.
- Patient selection is crucial for optimal PFO closure outcomes.
Purpose of the Study:
- To define the qualification process for PFO closure in CS patients.
- To analyze the clinical profiles of patients eligible for PFO closure.
- To identify key determinants for PFO closure eligibility.
Main Methods:
- Retrospective review of 276 patients assessed for PFO closure.
- Analysis of demographic, clinical, neuroimaging, and echocardiographic factors.
- Identification of eligibility criteria using statistical analysis.
Main Results:
- 132 patients (47.8%) were eligible for PFO closure.
- Eligible patients had higher rates of acute cerebral ischemia and stroke hospitalization.
- Eligible patients exhibited lower comorbidity (Charlson's Comorbidity Index) and higher RIPE scores.
Conclusions:
- Thorough clinical assessment is vital for PFO closure qualification.
- Balancing procedure benefits and risks is essential.
- Adherence to scientific society recommendations guides PFO closure decisions.
Background:
Nearly half of all patients with cryptogenic stroke (CS) have a patent foramen ovale (PFO). Percutaneous PFO closure is a well-established method for secondary prevention of CS and should be considered for individuals with the highest likelihood of a causal link between PFO and stroke.
Aims:
The study aimed to describe the qualification process and analyze the profiles of patients eligible for PFO closure as a secondary prevention strategy for CS.
Material And Methods:
This study involved a retrospective review of the medical records of patients who were assessed for PFO closure by the NeuroHeart Team. A total of 276 patients were included in the study. Of these, 132 patients (47.8%) were found to be eligible for PFO closure. Key determinants of patient eligibility for the procedure were identified based on a range of demographic, clinical, neuroimaging, and echocardiographic factors.
Results:
Qualified patients were less likely to be female (52.3% vs. 77.1%; P <0.001), had a higher incidence of acute cerebral ischemia - stroke or transient ischemic attack (P <0.001), were more frequently hospitalized for stroke/transient ischemic attack (82.6% vs. 29.9%; P <0.001), and were less likely to have non-ischemic central nervous system changes (12.9% vs. 50%; P <0.001). Additionally, qualified patients had lower comorbidity as expressed in Charlson's Comorbidity Index and achieved higher scores on the Risk of Paradoxical Embolism scale.
Conclusions:
During the qualification process for PFO closure, a patient's clinical profile should be thoroughly assessed, with careful consideration of the procedure's benefits and risks in line with current recommendations from scientific societies.
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01:15Ischemic Stroke ll: Pathophysiology
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