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

Nayan Agarwal; Harsh Golwala; Khalid K. Mojadidi

doi:10.1016/B978-0-12-816966-7.00007-5

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 proceeding › Chapter

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 language	English (US)
Title of host publication	Patent Foramen Ovale Closure for Stroke, Myocardial Infarction, Peripheral Embolism, Migraine, and Hypoxemia
Publisher	Elsevier
Pages	79-91
Number of pages	13
ISBN (Electronic)	9780128169667
DOIs	https://doi.org/10.1016/B978-0-12-816966-7.00007-5
State	Published - Jan 1 2019
Externally published	Yes

Keywords

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

ASJC Scopus subject areas

General Agricultural and Biological Sciences
General Biochemistry, Genetics and Molecular Biology

Access to Document

10.1016/B978-0-12-816966-7.00007-5

Cite this

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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.",

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AB - 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.

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

Abstract

Keywords

ASJC Scopus subject areas

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