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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

Author(s):

Harsha Santheshivara Nagarajarao *, Chandra Prakash Ojha, Archana Kedar and Debabrata Mukherjee   Pages 1 - 16 ( 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 right and left atria in approximately 25-27% of adults [1, 2].

In this review we examine the clinical relevance of the PFO with analysis of 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:

Cryptogenic stroke, Patent Foramen Ovale, Antiplatelet therapy, Anticoagulation, Trans-catheter closure

Affiliation:

Texas Tech University of Health Sciences, El Paso, TX, Texas Tech University of Health Sciences, El Paso, TX, Clinical instructor, University of Louisville school of medicine, Louisville, TX, Texas Tech University of Health Sciences, El Paso, TX



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