BEGIN YOUR JOURNEY TOWARDS PREVENTING CRYPTOGENIC STROKE
If you’ve had a stroke due to an unknown cause, learn how you may be able to prevent another with the Amplatzer™ PFO Occluder.
The United States and countries across the globe have updated their stroke guidelines to include PFO closure. See below for brief summaries of the guidelines, as well as links to the full publications.
Experts from the American Academy of Neurology, or AAN, carefully reviewed the available evidence about secondary stroke prevention in patients with a patent foramen ovale, or PFO. Based on their review, they conclude the following:
The Japan Stroke Society, Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics came together to review the evidence on PFO closure and recommend the following: PFO closure should be considered for patients younger than 60 years who have the diagnosis of a cryptogenic stroke and have a PFO. It is critical that the patient is able to take antithrombotic medication after device implantation.
Published by the Stroke Foundation, the Australian guidelines strongly recommend that in ischaemic stroke patients aged <60 in whom a patent foramen ovale is considered the likely cause of stroke after thorough exclusion of other causes, percutaneous closure of the PFO is recommended.
Physicians from cardiology, internal medicine and neurology joined together to publish new stroke guidelines related to PFO closure in patients with cryptogenic stroke. The guidelines state that interventional PFO closure should be performed in patients aged 16 to 60 years (after extensive neurological and cardiological diagnostic work-up) with a history of cryptogenic ischaemic stroke and patent foramen ovale, with moderate or extensive right-to-left shunt.
The Heart and Stroke Foundation Canadian Stroke Best Practice Committees recommend the following:
For carefully-selected patients with a recent ischemic stroke or TIA attributed to a PFO, PFO device closure plus long-term antiplatelet therapy is recommended over long-term antithrombotic therapy alone, provided all the following criteria are met:
In addition to guidelines, there have also been position papers and consensus statements published regarding PFO closure in patients with cryptogenic stroke.
With most of the evidence on PFO closure being obtained from Caucasian patients, a consensus statement was developed by Asian-Pacific clinical experts, accounting for the specific stroke and bleeding characteristics of Asian-Pacific patients and the specific Asian-Pacific context.
Key aspects of this consensus statement include:
It was emphasized that clinical evidence for the above aspects should be collected among Asian-Pacific patients.
EuroIntervention published a European position paper regarding the management of patients with PFO. The paper was developed by eight scientific societies and international stroke experts.
“Position of our societies to perform percutaneous closure of PFO in carefully selected patients from 18 to 65 years with confirmed cryptogenic stroke, TIA or systemic embolism and estimated high probability of causal role of PFO as assessed by clinical, anatomic and imaging features.”
“The interventional procedure must be proposed to each patient evaluating the individual probability of benefit based on an assessment of both the role of the PFO in the thromboembolic event and the expected results and risks of a lifelong medical therapy.”
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