A Modified Anatomical-Functional-RoPE (AF-RoPE) Score Improves Patient Selection for Patent Foramen Ovale Closure

Abstract

IntroductionAlthough recent trials [1] and meta-analysis about transcatheter closure of patent foramen ovale (PFO) [2][3][4][5][6][7] have suggested that PFO closure is both an effective and cost-effective treatment for recurrent embolic stroke, the management of patients with symptomatic PFO is not yet completely clarified. Recently, the RoPE score calculator has been proposed [8] in order to stratify the patients in whom PFO may be considered not a confounding but presumably a causative factor. This score is mainly based on clinical criteria and it doesn't include any anatomical or functional characteristics, such as permanent and/or large shunt, presence of atrial septum aneurysm (ASA) and long tunnelized PFO. Moreover, these PFO structural aspects have already been considered for both patient selection and clinical decision making

Transcranial Doppler Screening for Patent Foramen Ovale Closure in Cryptogenic Strokes in Young: A Single Center Experience from South India

“…Embolic stroke of the undetermined source was def ined as a non-lacunar infarct (subcortical infarct ≤1.5 cm on CT or ≤2.0 cm on MRI) in the absence of the following: extracranial or intracranial atherosclerosis causing >50% luminal stenosis patients at high risk for recurrence who may benefit with PFO closure. 13 Recent studies have shown the importance of identifying high-risk PFOs and the benefits of PFO closure for secondary stroke prevention. 14 These observations are supported by findings of the CLOSE and DEFENSE-PFO trials which included only high-risk PFO patients.…”