Management of patients with stroke and a patent foramen ovale

Carlos J. Rodriguez, Shunichi Homma

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Observational studies have established a strong association between the presence of patent foramen ovale (PFO) and increased risk of ischemic stroke. The mechanism involved is presumed to be a paradoxical embolism from a venous thrombus that travels via the PFO to the systemic circulation. The best treatment modality to prevent recurrent stroke in patients with PFO remains undefined. There are four major choices: 1) medical therapy with anticoagulants, 2) medical therapy with antiplatelet agents, 3) surgical closure, and 4) percutaneous device closure. The Patent Foramen Ovate in Cryptogenic Stroke Study has demonstrated that antiplatelet and anticoagulant therapies are of equal benefit in preventing recurrent neurologic events in stroke patients with a PFO. Medical therapy should remain as the initial choice of secondary prophylactic therapy. PFO closure, either surgical or percutaneous, may further reduce event rates; however, this remains to be demonstrated because no randomized trial to date has compared PFO closure with medical therapy.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalCurrent Neurology and Neuroscience Reports
Volume4
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Fingerprint

Patent Foramen Ovale
Stroke
Anticoagulants
Therapeutics
Paradoxical Embolism
Platelet Aggregation Inhibitors
Nervous System
Observational Studies
Thrombosis
Equipment and Supplies

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Management of patients with stroke and a patent foramen ovale. / Rodriguez, Carlos J.; Homma, Shunichi.

In: Current Neurology and Neuroscience Reports, Vol. 4, No. 1, 01.2004, p. 19-22.

Research output: Contribution to journalReview article

@article{456ab8d535aa4ef4a6592225e6226f61,
title = "Management of patients with stroke and a patent foramen ovale",
abstract = "Observational studies have established a strong association between the presence of patent foramen ovale (PFO) and increased risk of ischemic stroke. The mechanism involved is presumed to be a paradoxical embolism from a venous thrombus that travels via the PFO to the systemic circulation. The best treatment modality to prevent recurrent stroke in patients with PFO remains undefined. There are four major choices: 1) medical therapy with anticoagulants, 2) medical therapy with antiplatelet agents, 3) surgical closure, and 4) percutaneous device closure. The Patent Foramen Ovate in Cryptogenic Stroke Study has demonstrated that antiplatelet and anticoagulant therapies are of equal benefit in preventing recurrent neurologic events in stroke patients with a PFO. Medical therapy should remain as the initial choice of secondary prophylactic therapy. PFO closure, either surgical or percutaneous, may further reduce event rates; however, this remains to be demonstrated because no randomized trial to date has compared PFO closure with medical therapy.",
author = "Rodriguez, {Carlos J.} and Shunichi Homma",
year = "2004",
month = "1",
doi = "10.1007/s11910-004-0006-8",
language = "English (US)",
volume = "4",
pages = "19--22",
journal = "Current Neurology and Neuroscience Reports",
issn = "1528-4042",
publisher = "Current Medicine Group",
number = "1",

}

TY - JOUR

T1 - Management of patients with stroke and a patent foramen ovale

AU - Rodriguez, Carlos J.

AU - Homma, Shunichi

PY - 2004/1

Y1 - 2004/1

N2 - Observational studies have established a strong association between the presence of patent foramen ovale (PFO) and increased risk of ischemic stroke. The mechanism involved is presumed to be a paradoxical embolism from a venous thrombus that travels via the PFO to the systemic circulation. The best treatment modality to prevent recurrent stroke in patients with PFO remains undefined. There are four major choices: 1) medical therapy with anticoagulants, 2) medical therapy with antiplatelet agents, 3) surgical closure, and 4) percutaneous device closure. The Patent Foramen Ovate in Cryptogenic Stroke Study has demonstrated that antiplatelet and anticoagulant therapies are of equal benefit in preventing recurrent neurologic events in stroke patients with a PFO. Medical therapy should remain as the initial choice of secondary prophylactic therapy. PFO closure, either surgical or percutaneous, may further reduce event rates; however, this remains to be demonstrated because no randomized trial to date has compared PFO closure with medical therapy.

AB - Observational studies have established a strong association between the presence of patent foramen ovale (PFO) and increased risk of ischemic stroke. The mechanism involved is presumed to be a paradoxical embolism from a venous thrombus that travels via the PFO to the systemic circulation. The best treatment modality to prevent recurrent stroke in patients with PFO remains undefined. There are four major choices: 1) medical therapy with anticoagulants, 2) medical therapy with antiplatelet agents, 3) surgical closure, and 4) percutaneous device closure. The Patent Foramen Ovate in Cryptogenic Stroke Study has demonstrated that antiplatelet and anticoagulant therapies are of equal benefit in preventing recurrent neurologic events in stroke patients with a PFO. Medical therapy should remain as the initial choice of secondary prophylactic therapy. PFO closure, either surgical or percutaneous, may further reduce event rates; however, this remains to be demonstrated because no randomized trial to date has compared PFO closure with medical therapy.

UR - http://www.scopus.com/inward/record.url?scp=1542750031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1542750031&partnerID=8YFLogxK

U2 - 10.1007/s11910-004-0006-8

DO - 10.1007/s11910-004-0006-8

M3 - Review article

C2 - 14683623

AN - SCOPUS:1542750031

VL - 4

SP - 19

EP - 22

JO - Current Neurology and Neuroscience Reports

JF - Current Neurology and Neuroscience Reports

SN - 1528-4042

IS - 1

ER -