PFO Closure for Cryptogenic Stroke: Review of New Data and Results

Cerebrovascular Disease and Stroke (C Helgason and M Alberts, Section Editors)

Opinion statement

Observational studies over 20 years have suggested that a patent foramen ovale (PFO) is an important cause of cryptogenic stroke in young individuals; case series and registries suggest that PFO closure confers superior protection from recurrent transient ischemic attack (TIA) and stroke. Recently completed randomized clinical trials did not confirm this hypothesis, but have provided reassurance that the risk of recurrent stroke is low at 1.5 %/yr. A target subset that may benefit are those with ischemic stroke, a large right-to-left shunt, and an atrial septal aneurysm. Further study is needed to determine the optimum strategy to reduce the long-term stroke risk in a lifetime of varying situational risk factors and temporary interruptions of medical therapies.

Keywords

Patent foramen ovale PFO occlude device Atrial septal aneurysm Cryptogenic stroke Stroke of undetermined cause Atrial fibrillation 

Notes

Conflict of Interest

Dr. Shyam Rao reported no potential conflicts of interest relevant to this article.

Dr. Cathy Sila reported receiving grants from NMT and Aga-Medical.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of great importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Internal MedicineFairview HospitalClevelandUSA
  2. 2.Comprehensive Stroke CenterUniversity Hospitals - Case Medical CenterClevelandUSA
  3. 3.Department NeurologyCase Western Reserve School of MedicineClevelandUSA

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