Patent Foramen Ovale Closure in Cryptogenic Stroke: Limited Data, Continued Debate

An expert panel recommends PFO closure in most scenarios for patients <60, but some of the data — and, therefore, the recommendations — are weak.

Sponsoring Organization: BMJ Rapid Recommendations — a collaboration between the nonprofit MAGIC group and the BMJ

Target Audience: Clinicians caring for patients with PFO who have had a cryptogenic ischemic stroke

Background

Patent foramen ovale (PFO) has been postulated to be a cause of cryptogenic ischemic stroke, especially in patients under 60 years old. Until recently, results of clinical trials comparing PFO closure with medical therapy were negative, and there was no conclusive benefit seen with PFO closure. New data published in 2017 (NEJM JW Neurol Nov 2017 and N Engl J Med 2017; 377:1011, 1022, 1033) showed some evidence of benefit with PFO closure, but the extent of the benefit was unclear. A multidisciplinary group including neuro…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke