Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

摘要

Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debatedtopic. Recent clinical trials have unequivocally established the relationship between cryptogenicstrokes and paradoxical embolism across the PFO. This slit-like communication exists in everyonebefore birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communicationbetween the right and left atria in approximately 25-27% of adults.In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluatingcatheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examiningthe use of antiplatelet medications versus anticoagulants for stroke prevention in those patientswith PFO who do not qualify for closure per current guidelines.