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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

[ Vol. 18 , Issue. 2 ]

Author(s):

Harsha S. Nagarajarao *, Chandra P. Ojha, Archana Kedar and Debabrata Mukherjee   Pages 135 - 150 ( 16 )

Abstract:


Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between 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 evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

Keywords:

Anticoagulation, antiplatelet therapy, cryptogenic stroke, patent foramen ovale, trans-catheter closure, stroke prevention.

Affiliation:

Department of Medicine, Texas Tech University of Health Sciences, El Paso, TX, Department of Medicine, Texas Tech University of Health Sciences, El Paso, TX, Department of Medicine, Clinical Instructor, University of Louisville, Kentucky, Louisville, Kentucky, Department of Medicine, Texas Tech University of Health Sciences, El Paso, TX



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