Cryptogenic stroke and patent foramen ovale (abridged and translated version).
Hans-Christoph DienerArmin GrauStephan BaldusPublished in: Neurological research and practice (2019)
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: Diener, HC., für die Deutsche Gesellschaft für Neurologie (DGN), Grau, A.J. et al. Nervenarzt (2018) 89: 1143. 10.1007/s00115-018-0609-y.
Keyphrases
- antiplatelet therapy
- atrial fibrillation
- pulmonary embolism
- percutaneous coronary intervention
- acute coronary syndrome
- end stage renal disease
- ejection fraction
- oral anticoagulants
- inferior vena cava
- heart failure
- chronic kidney disease
- newly diagnosed
- left atrial
- psychometric properties
- coronary artery disease
- peritoneal dialysis
- low dose
- risk factors
- type diabetes
- venous thromboembolism
- systematic review
- left atrial appendage
- high intensity
- prognostic factors
- cerebral ischemia
- pulmonary artery
- blood brain barrier
- meta analyses
- coronary artery
- patient reported outcomes