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Percutaneous closure of patent foramen ovale for cryptogenic stroke: A meta-analysis of randomized controlled trials
Conclusions: Currently-available randomized data do not support the use of percutaneous PFO closure for secondary stroke prevention in patients with cryptogenic stroke and PFO. An updated meta-analysis including further data from ongoing RCTs is warranted.
Source: International Journal of Cardiology - July 26, 2013 Category: Cardiology Authors: Joey S.W. Kwong, Yat-Yin Lam, Cheuk-Man Yu Tags: Original Articles Source Type: research

PFO closure vs. medical therapy in cryptogenic stroke or transient ischemic attack: A systematic review and meta-analysis
Conclusions: This meta-analysis does not support PFO closure for secondary prevention with unselected devices in cryptogenic stroke/TIA. In subgroup analysis, selected closure devices may be superior to medical therapy without increasing the risk of new-onset AF, however. This observation should be confirmed in further trials using inclusion criteria for patients with high likelihood of PFO-related stroke recurrence.
Source: International Journal of Cardiology - September 16, 2013 Category: Cardiology Authors: G. Ntaios, V. Papavasileiou, K. Makaritsis, P. Michel Tags: Reviews Source Type: research

Simultaneous onset of myocardial infarction and ischemic stroke in a patient with atrial fibrillation: Multiple territory injury revealed on angiography and magnetic resonance
An 84-year-old man with a history of hypertension and paroxysmal atrial fibrillation (AF) who received no anticoagulant drugs experienced acute chest pain and transient loss of consciousness. He was transferred to our emergency room. His initial electrocardiogram showed sinus rhythm with ST-segment elevation in the I, aVL, and V1–V6 leads. His blood pressure was 158/92mmHg and his pulse was regular at 70beats per minute. A chest radiograph showed increased heart size and pulmonary vascular congestion. His troponin T level was elevated (more than 0.1ng/mL). He was diagnosed with ST-elevation myocardial infarction (MI) and...
Source: International Journal of Cardiology - February 4, 2014 Category: Cardiology Authors: Osamu Hashimoto, Kozo Sato, Yohei Numasawa, Joji Hosokawa, Masahiro Endo Tags: Online Letters to the Editor Source Type: research

Randomized trials of closure of persistant foramen ovale (PFO) vs medical therapy for patients with cryptogenic stroke – effect of lost-to-follow-up and withdrawal of consent
Foramen ovale is a remnant of the fetal circulation that can be found in all newly born infants and that remain open in about a quarter of adults and the presence of a persistent, or patent, foramen ovale, PFO is associated with cryptogenic stroke [1]. In several observational case-series, cohort studies and registries, device closure of PFO is associated with a significantly lower risk of recurrent stroke or transitory ischemia attacks, TIAs. In the three until today published randomized trials this has not been corroborated however [2–4].
Source: International Journal of Cardiology - January 14, 2016 Category: Cardiology Authors: Mikael Dellborg, Peter Eriksson Source Type: research

Randomized trials of closure of persistent foramen ovale (PFO) vs medical therapy for patients with cryptogenic stroke — Effect of lost-to-follow-up and withdrawal of consent
Foramen ovale is a remnant of the fetal circulation that can be found in all newly born infants and that remain open in about a quarter of adults and the presence of a persistent, or patent, foramen ovale, PFO is associated with cryptogenic stroke [1]. In several observational case-series, cohort studies and registries, device closure of PFO is associated with a significantly lower risk of recurrent stroke or transitory ischemia attacks, TIAs. In the three until today published randomized trials this has not been corroborated however [2–4].
Source: International Journal of Cardiology - January 14, 2016 Category: Cardiology Authors: Mikael Dellborg, Peter Eriksson Tags: Correspondence Source Type: research

Patent foramen ovale closure for recurrent stroke prevention: Recent evidence towards individualized decision-making
We read with great interest the meta-analysis by Piccolo and colleagues that showed a reduction in the recurrent stroke risk after patent foramen ovale (PFO) closure compared with medical therapy in patients with embolic stroke of unknown origin [1].
Source: International Journal of Cardiology - April 19, 2022 Category: Cardiology Authors: Akshay Goel, Mayank Singhal, Aaqib H. Malik, Rahul Gupta, Dhrubajyoti Bandyopadhyay Tags: Letter to the Editor Source Type: research

Stroke prevention by percutaneous closure of patent foramen ovale: A meta-analytic review
Recently, in the span of six months twelve meta-analyses have been published regarding patent foramen ovale transcatheter closure vs. medical therapy on recurrent vascular events . The trials included were CLOSURE I trial , the RESPECT trial and the PC-Trial . The most important issue is that all three randomized clinical trials had negative results and four of the subsequent meta-analyses conclude that there is no benefit. Patent foramen ovale (PFO) closure appears to reduce the risk of recurrent vascular events compared with medical treatment, according to The Institute for Heart and Vascular Health and Cardiovascular Di...
Source: International Journal of Cardiology - February 3, 2014 Category: Cardiology Authors: Vinayak Nagaraja, Guy D. Eslick Tags: Letters to the Editor Source Type: research

Recurrent stroke in patients with patent foramen ovale: An observational prospective study of percutaneous closure of PFO versus non-closure
This study aims to compare long-term outcomes of PFO closure versus non-closure.
Source: International Journal of Cardiology - May 20, 2015 Category: Cardiology Authors: Naqibullah Mirzada, Per Ladenvall, Per-Olof Hansson, Peter Eriksson, Mikael Dellborg Source Type: research

Patent foramen ovale closure vs. medical therapy for recurrent stroke prevention: Evolution of treatment effect during follow-up
Little is known regarding changes in treatment effect over time associated with patent foramen ovale (PFO) closure among patients with embolic stroke of unknown origin.
Source: International Journal of Cardiology - January 3, 2018 Category: Cardiology Authors: Raffaele Piccolo, Anna Franzone, George C.M. Siontis, Stefan Stortecky, Thomas Pilgrim, Bernhard Meier, Stephan Windecker Tags: Short communication Source Type: research

Quality of life after percutaneous closure of patent foramen ovale in patients after cryptogenic stroke compared to a normative sample
Despite the widespread use of percutaneous closure of patent foramen ovale (PFO) in patients after a cryptogenic stroke, little is known about its impact on health-related quality of life (HRQoL). The aim of this study was to assess HRQoL in these patients compared to PFO patients not considered candidates for percutaneous closure, and to a normal population.
Source: International Journal of Cardiology - February 4, 2018 Category: Cardiology Authors: Naqibullah Mirzada, Per Ladenvall, Per-Olof Hansson, Peter Eriksson, Charles Taft, Mikael Dellborg Source Type: research

Patent foramen ovale after cryptogenic stroke: When is it justifiable to close it?
The incidence of patent foramen ovale (PFO) has been reported as high as 27% [1]. A strong association between cryptogenic stroke and PFO suggested that paradoxical embolism may be the culprit for such unexplained strokes. Several pathophysiological hypotheses have been proposed to explain paradoxical embolism: right ventricular dysfunction or decreased compliance, preferential flow from the inferior vena cava through the PFO, sometimes associated with an exuberant Eustachian valve or clot formation within an aneurysmal septum [2].
Source: International Journal of Cardiology - June 8, 2018 Category: Cardiology Authors: Alain Fraisse, Giovanni di Salvo, John C. Janssen, Sonya V. Babu-Narayan, Michael A. Gatzoulis Tags: Editorial Source Type: research

Net clinical benefit of patent foramen ovale closure in patients with cryptogenic stroke: Meta-analysis and meta-regression of randomized trials
Controlled randomized trials (CRTs) comparing the efficacy of patent foramen ovale (PFO) closure and medical therapy in patients with cryptogenic stroke have yielded heterogeneous results. No data are available on the net clinical benefit with the two strategies.
Source: International Journal of Cardiology - June 8, 2018 Category: Cardiology Authors: Vincenzo Pasceri, Francesco Pelliccia, Edoardo Bressi, Ludmilla Mantione, Carlo Gaudio, Giulio Speciale, Roxana Mehran, George D. Dangas, Giuseppe Patti Source Type: research

Cost effectiveness and clinical efficacy of patent foramen ovale closure as compared to medical therapy in cryptogenic stroke patients: A detailed cost analysis and meta-analysis of randomized controlled trials
Up to half the patients with cryptogenic stroke under the age of 55  years have been found to have a PFO. Observational studies have demonstrated a benefit from closure of PFO and several RCTs have shown a trend toward benefit. The cost and clinical effectiveness of PFO closure is unclear.
Source: International Journal of Cardiology - July 21, 2018 Category: Cardiology Authors: Christopher A. Pickett, Todd C. Villines, Jon R. Resar, Edward A. Hulten Source Type: research

Patent foramen ovale and paradoxical thromboembolism. Which treatment is the most appropriate?
Patent foramen ovale (PFO) has been associated with a higher frequency of cryptogenic stroke, transient ischemic attack and migraines. PFO treatment, based on percutaneous closure versus non-closure with medical therapy, remains controversial with a general tendency to propose a closure for symptomatic patients for transient ischemic attack or stroke [1–10].
Source: International Journal of Cardiology - January 9, 2016 Category: Cardiology Authors: Francesco Masetti, Patrizia Borra, Salvatore Maviglia Tags: Correspondence Source Type: research

Percutaneous patent foramen ovale occlusion: Current evidence and evolving clinical practice
This article reviews the associations between PFO and the three main implicated pathologies as well as the evidence for PFO closure in the current era.
Source: International Journal of Cardiology - September 25, 2013 Category: Cardiology Authors: Ming Chern Leong, Anselm Uebing, Michael A. Gatzoulis Tags: Reviews Source Type: research

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