Closure of Patent Foramen Ovale Versus Medical Therapy in Patients With Cryptogenic Stroke or Transient Ischemic Attack

Ntaios, George; Papavasileiou, Vasileios; Sagris, Dimitrios; Makaritsis, Konstantinos; Vemmos, Konstantinos; Steiner, Thorsten; Michel, Patrik

doi:10.1161/strokeaha.117.020030

Cited by 108 publications

(72 citation statements)

References 19 publications

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“…Our findings were consistent with the findings of one recent meta‐analysis of 5 RCTs . We added all high‐quality observational studies in our meta‐analysis, which showed more general efficacy from PFO closure.…”

Section: Discussionsupporting

confidence: 91%

“…In contrary, the results from recent RCTs showed a lower risk of recurrent stroke when PFO was closed comparing to medical therapy . This finding has been supported by a meta‐analysis of RCTs recently …”

Section: Introductionmentioning

confidence: 82%

“…However, there was no effect on TIA recurrence, all-cause mortality, Our findings were consistent with the findings of one recent meta-analysis of 5 RCTs. 12 We added all high-quality observational studies in our meta-analysis, which showed more general efficacy from PFO closure. In our analysis, we also added subgroup of gender, age, ASA, and shunt size for which all had clinical significance.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta‐analysis of 5 randomized controlled trials and 14 observational studies

Chen

Dong

et al. 2018

CNS Neurosci Ther

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta‐analysis of 5 randomized controlled trials and 14 observational studies

Chen

Dong

et al. 2018

CNS Neurosci Ther

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“…There are two options for prevention of recurrent ischemic stroke, including medical antithrombotic agents and catheter closure of the defect. Transcatheter PFO closure reveals less recurrent ischemic stroke compared to medical treatment [8]. In another multinational randomized trial, PFO closure combined with antiplatelet therapy revealed less subsequent ischemic stroke (1.4%) compared to antiplatelet alone (5.4%).…”

Section: Discussionmentioning

confidence: 96%

Recent review of transcatheter closure of atrial septal defect

Yang

2018

The Kaohsiung J of Med Scie

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Atrial septal defect (ASD) is one of the two most common congenital heart diseases in children and adult. After the application of catheter intervention for ASD, this became an alternative treatment other than surgery from late 1990. In 2001, the procedure was further approved by the US Food and Drug Administration (FDA), and become the first choice for most cases of secundum type of ASD worldwide. The success rate is more than 98% in literature reviews, with low complication rates in percutaneous ASD closure. Major complications are around 1%, including device embolization, cardiac erosions, new-onset atrial arrhythmia, and other comorbidities. We reviewed indications for percutaneous secundum type ASD closure, technique, successful rate and major complications in this article. To complete the catheter intervention with difficult ASD conditions, various procedural techniques have been developed recently. We also report a challenging case by a current balloon-assisted technique for huge ASD closure.

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“…The study was funded by the French Ministry of Health. In summary, the CLOSE study shows a therapeutic benefit of Table 1 Design and baseline data from the six randomised studies on PFO closure in cryptogenic stroke [9,11,23 PFO closure versus drug therapy alone in a patent foramen ovale with large shunt volume or atrial septal aneurysm in patients aged below 60 years with cryptogenic stroke, and no difference between anticoagulation and APT. The REDUCE study compared the closure of a patent foramen ovale with subsequent APT, with therapy with APT alone in patients with patent foramen ovale and cryptogenic stroke [8].…”

Section: Recent Randomised Studiesmentioning

confidence: 99%

Cryptogenic stroke and patent foramen ovale (abridged and translated version)

Diener

Grau

Baldus

2019

Neurol. Res. Pract.

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Interventional patent foramen ovale (PFO) closure should be performed in patients aged 16 to 60 years (after extensive neurological and cardiological diagnostic work-up) with a history of cryptogenic ischaemic stroke and patent foramen ovale, with moderate or extensive right-to-left shunt. In patients with cryptogenic ischaemic stroke and patent foramen ovale, who reject a PFO closure, there is no evidence of superiority of oral anticoagulation over antiplatelet therapy. Therefore, secondary prevention should be performed with aspirin or clopidogrel. Atrial fibrillation, pericardial tamponade, and pulmonary embolism are reported complications during and after implantation of an occluder. However, these events are so rare that they should not influence the recommendation for implantation. This article is an abridged and translated version of the guideline published in Nervenarzt:

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Closure of Patent Foramen Ovale Versus Medical Therapy in Patients With Cryptogenic Stroke or Transient Ischemic Attack

Cited by 108 publications

References 19 publications

Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta‐analysis of 5 randomized controlled trials and 14 observational studies

Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta‐analysis of 5 randomized controlled trials and 14 observational studies

Recent review of transcatheter closure of atrial septal defect

Cryptogenic stroke and patent foramen ovale (abridged and translated version)

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