Management of patients with stroke and a patent foramen ovale

Carlos J. Rodriguez, Shunichi Homma

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

Observational studies have established a strong association etween 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 Ovale 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)143-146
Number of pages4
JournalCurrent cardiology reports
Volume6
Issue number2
DOIs
Publication statusPublished - Mar 2004
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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