Additional Factors in Considering Patent Foramen Ovale Closure to Prevent Recurrent Ischemic Stroke

To the Editor In his Viewpoint, Kamel addresses some issues with the randomized clinical trials (RCTs) of patent foramen ovale (PFO) closure for preventing recurrent stroke and urges a judicious and evidence-based approach for patient selection. I would like to point out additional factors that further demonstrate need for extreme caution in selecting patients to undergo this procedure.
Source: JAMA Neurology - Category: Neurology Source Type: research

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CONCLUSIONS: Although a big step forward that will benefit many patients has been taken with recent trials, many questions remain unanswered. Pending results from further studies, decision-making regarding management of patients with PFO-associated ischaemic stroke should be based on a close coordination between neurologists/stroke specialists and cardiologists. PMID: 31787326 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
AbstractPurpose of reviewCryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic – and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes – the concept of embolic stroke of undetermined source (ESUS) (Hart et al....
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of reviewTo highlight recent advancements in the management of acute ischemic stroke patients with patent foramen ovale (PFO).Recent findingsOne significant recent development was publication of long-term follow-up data from the RESPECT trial demonstrating evidence in favor of PFO closure over medical management. This data subsequently led to FDA approval for AMPLATZER ™ septal occluder in the treatment of patients aged 18 to 60 years with both PFO and no other determined etiology for ischemic stroke, otherwise referred to as embolic stroke of undetermined source. Several subsequent closure trial...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Ka U Lio, Maruti Kumaran, Parth RaliLung India 2019 36(6):564-566
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
Abstract Stroke still remains a major cause of death and disability worldwide. Ischemic stroke is the most common type of stroke. Causes of ischemic stroke can be classified into large-artery atherosclerosis, cardiogenic embolism, small-vessel disease, stroke of other determined etiology, and stroke of undetermined etiology. Stroke causes in adults are mainly attributable to classical cardiovascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. In neuroimaging, stroke subtypes can be defined according to lesion localization and distribution (territorial infarct, lacunar infarct, h...
Source: Hamostaseologie - Category: Hematology Authors: Tags: Hamostaseologie Source Type: research
Gore won the European CE Mark for its GORE CARDIOFORM ASD Occluder, a device designed for percutaneous, transcatheter closure of ostium secundum atrial defects (ASDs). The occluder recently completed a clinical study involving 125 patients with ASD, ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiac Surgery Cardiology Radiology Source Type: blogs
Publication date: Available online 1 October 2019Source: Revista Española de Cardiología (English Edition)Author(s): Jérôme Wintzer-Wehekind, Alberto Alperi, Christine Houde, Jean-Marc Côté, David del Val, Mélanie Côté, Josep Rodés-CabauAbstractIntroduction and objectivesRandomized trials have shown the efficacy of transcatheter closure of patent foramen ovale (PFO) in patients aged ≤ 60 years with cryptogenic embolism. We aimed to assess the long-term safety and efficacy of PFO closure in patients aged > 60 years.MethodsOf 475 consecutive patien...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
PMID: 31569246 [PubMed - in process]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
CONCLUSION: The IrisFIT PFO Closure System can be used safely and with high technical success for secondary prevention of cryptogenic stroke or peripheral embolization. PMID: 31522140 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
AbstractFew data are available on age-related burden and characteristics of embolic stroke of undetermined source (ESUS) in the real world clinical practice. The aim of our study was to provide information about it. We retrospectively analyzed data of patients consecutively admitted to our Stroke Unit along 1  year (2017, November 1st–2018, October 31st). The etiology of ischemic stroke was defined at hospital discharge; ESUS was considered as a subset of cryptogenic stroke, and defined according to the 2014 international criteria. In the analyzed period, 306 patients, 52.3% females, mean age ±&thi...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
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