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Stroke Prevention in Patients with Patent Foramen Ovale.

Publication ,  Journal Article
Thaler, A; Kvernland, A; Kelly, S; Song, C; Aparicio, HJ; Mac Grory, B; Yaghi, S
Published in: Curr Cardiol Rep
October 30, 2021

PURPOSE OF REVIEW: Patent foramen ovale (PFO) is widely prevalent and studies have suggested an association with ischemic stroke. In this review, we aim to highlight current management of patients with ischemic stroke in the setting of PFO and discuss some areas of controversy. RECENT FINDINGS: Upon reviewing the literature, we have found that the evidence regarding the management of patients with cryptogenic stroke and PFO has come a long way in the past several years, and many uncertainties remain in clinical practice. The Risk of Paradoxical Embolism (RoPE) score helps to predict the probability of a pathogenic PFO, and recent trial data confirms the benefit of closure in carefully selected patients. The benefit of closure in older patients and in patients with alternate, competing mechanisms is still uncertain, and the long-term risks of closure are not known. Finally, the efficacy of direct oral anticoagulants (DOACs) in this patient population as compared to other medical therapy or mechanical closure has not yet been investigated. Randomized data is needed to help answer these questions. PFO closure is a safe and effective strategy in reducing stroke risk in carefully selected patients with cryptogenic stroke in the setting of a PFO. More studies are needed to test optimal medical treatment strategies and the safety and efficacy of PFO closure in patient subgroups not included in prior PFO closure trials.

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Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

October 30, 2021

Volume

23

Issue

12

Start / End Page

183

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke
  • Secondary Prevention
  • Recurrence
  • Humans
  • Foramen Ovale, Patent
  • Embolism, Paradoxical
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Aged
 

Citation

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Thaler, A., Kvernland, A., Kelly, S., Song, C., Aparicio, H. J., Mac Grory, B., & Yaghi, S. (2021). Stroke Prevention in Patients with Patent Foramen Ovale. Curr Cardiol Rep, 23(12), 183. https://doi.org/10.1007/s11886-021-01605-0
Thaler, Alison, Alexandra Kvernland, Sean Kelly, Christopher Song, Hugo J. Aparicio, Brian Mac Grory, and Shadi Yaghi. “Stroke Prevention in Patients with Patent Foramen Ovale.Curr Cardiol Rep 23, no. 12 (October 30, 2021): 183. https://doi.org/10.1007/s11886-021-01605-0.
Thaler A, Kvernland A, Kelly S, Song C, Aparicio HJ, Mac Grory B, et al. Stroke Prevention in Patients with Patent Foramen Ovale. Curr Cardiol Rep. 2021 Oct 30;23(12):183.
Thaler, Alison, et al. “Stroke Prevention in Patients with Patent Foramen Ovale.Curr Cardiol Rep, vol. 23, no. 12, Oct. 2021, p. 183. Pubmed, doi:10.1007/s11886-021-01605-0.
Thaler A, Kvernland A, Kelly S, Song C, Aparicio HJ, Mac Grory B, Yaghi S. Stroke Prevention in Patients with Patent Foramen Ovale. Curr Cardiol Rep. 2021 Oct 30;23(12):183.
Journal cover image

Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

October 30, 2021

Volume

23

Issue

12

Start / End Page

183

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stroke
  • Secondary Prevention
  • Recurrence
  • Humans
  • Foramen Ovale, Patent
  • Embolism, Paradoxical
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Aged