Patent Foramen Ovale Science: Keeping the Horse in Front of the Cart∗

Compared with a prevalence of 25% in the general population, the higher prevalence of patent foramen ovale (PFO) in cryptogenic stroke (CS) patients has led to the intuitive conclusion that PFO is a risk factor for CS . However, distinguishing truly culpable PFOs from the innocent bystanders has been difficult. Some have advocated closure for just about any PFO , an approach which subjects people (many are not yet “patients” with any PFO-related neurological or other clinical syndrome) to procedural and device-related risks. This clearly puts the cart before the horse. PFO closure for secondary stroke prevention continues to be controversial even after 3 published randomized clinical trials . Primary stroke prevention with PFO closure is entirely unstudied.
Source: Journal of the American College of Cardiology - Category: Cardiology Authors: Tags: Patent Foramen Ovale and Stroke: Editorial Comment Source Type: research