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The role of device closure of patent foramen ovale in patients with cryptogenic stroke
- Source :
- Journal of Internal Medicine. 288:400-409
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- One of the most frequent causes of cardiac embolism in cryptogenic stroke is a paradoxical embolus, which originate from systemic venous source though an unidentified patent foramen ovale (PFO). PFO is a common finding in the general population with a prevalence of 25% to 30%. Transcatheter PFO device closure is known to be feasible and safety treatment for such patients. In recent years, several randomized controlled trials (RCTs) have been conducted to address the superiority of PFO closure over medical therapy alone in the prevention of stroke recurrence in patients with PFO. In contrast to findings from early 3 RCTs, recent 4 RCTs could successfully show the benefits of PFO device closure compared with medical therapy, with less peri- and postprocedural complication. Based on these data, PFO device closure is recommended to carefully select cryptogenic stroke patients aged from 18 to 65 years, with a high probability of a causal role of the PFO in stroke events. However, it is still uncertain whether PFO closure is superior to oral anticoagulants therapy in these patients. Therefore, further prospective randomized trials are needed to address the efficacy of PFO device closure to oral anticoagulants therapy.
- Subjects :
- 0301 basic medicine
Cardiac Catheterization
medicine.medical_specialty
Septal Occluder Device
Cost-Benefit Analysis
Population
Foramen Ovale, Patent
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Randomized controlled trial
law
Secondary Prevention
Internal Medicine
Humans
Medicine
In patient
Closure (psychology)
education
Stroke
Ischemic Stroke
education.field_of_study
business.industry
medicine.disease
Surgery
Cryptogenic stroke
030104 developmental biology
Patent foramen ovale
business
Complication
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 13652796 and 09546820
- Volume :
- 288
- Database :
- OpenAIRE
- Journal :
- Journal of Internal Medicine
- Accession number :
- edsair.doi.dedup.....ffb43f1ec4e9d49d1d5c89ec160666d5