PURPOSE OF REVIEW: To highlight recent advancements in the management of acute ischemic stroke patients with patent foramen ovale (PFO). RECENT FINDINGS: One 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 results have recently been published, which also demonstrated benefit of PFO closure over medical management for ischemic stroke risk reduction in select patients. Based on the results of the more recently published REDUCE trial, the FDA granted approval for the GORE™ septal occluder. There is current, well-established evidence that PFO closure for secondary stroke prevention is effective in select cases.
PURPOSE OF REVIEW: To highlight recent advancements in the management of acute ischemic strokepatients with patent foramen ovale (PFO). RECENT FINDINGS: One 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 results have recently been published, which also demonstrated benefit of PFO closure over medical management for ischemic stroke risk reduction in select patients. Based on the results of the more recently published REDUCE trial, the FDA granted approval for the GORE™ septal occluder. There is current, well-established evidence that PFO closure for secondary stroke prevention is effective in select cases.
Authors: Hans-Christoph Diener; Ralph L Sacco; J Donald Easton; Christopher B Granger; Richard A Bernstein; Shinichiro Uchiyama; Jörg Kreuzer; Lisa Cronin; Daniel Cotton; Claudia Grauer; Martina Brueckmann; Marina Chernyatina; Geoffrey Donnan; José M Ferro; Martin Grond; Bernd Kallmünzer; Jerzy Krupinski; Byung-Chul Lee; Robin Lemmens; Jaime Masjuan; Miroslav Odinak; Jeffrey L Saver; Peter D Schellinger; Danilo Toni; Kazunori Toyoda Journal: N Engl J Med Date: 2019-05-16 Impact factor: 91.245