Newer randomized trials of pfo closure for stroke (close, reduce and defense-pfo)

Nayan Agarwal, Harsh Golwala, Khalid K. Mojadidi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Patent foramen ovale (PFO) is found in 20%-25% of adults, but nearly 60% of those with otherwise cryptogenic stroke are found to have a PFO. The value of the use of percutaneous PFO closure, as a means of preventing recurrent paradoxical embolism, has been debated for years. Although early randomized trials did not demonstrate a statistically significant benefit of PFO closure over medical therapy for secondary prevention of stroke, 3 newer randomized trials (CLOSE, REDUCE, DEFENSE-PFO) and long-term follow-up data from RESPECT documented superiority of device closure. In this chapter, these newer trials are described as well as the meta-analysis of these studies. The lessons learned from these trials have led to the identification of stroke patients who benefit from PFO closure, and those who receive the highest clinical yield from device closure.

Original languageEnglish (US)
Title of host publicationPatent Foramen Ovale Closure for Stroke, Myocardial Infarction, Peripheral Embolism, Migraine, and Hypoxemia
PublisherElsevier
Pages79-91
Number of pages13
ISBN (Electronic)9780128169667
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Keywords

  • Cryptogenic stroke
  • PFO occluder
  • Paradoxical embolism
  • Patent foramen ovale
  • Transient ischemic attack

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)

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