ACP Journal Club. Patent foramen ovale closure and medical therapy did not differ for recurrence after cryptogenic stroke.
نویسنده
چکیده
20 August 2013 | ACP Journal Club | Volume 159 • Number 4 © 2013 American College of Physicians Advocates of interventional therapy criticized this trial for its choice of device and for using TIA as both a selection criterion and endpoint. The 2 new trials by Carroll and colleagues and Meier and colleagues address these concerns. They used a different device from that used in CLOSURE I and found a lower rate of complications but no benefit for stroke reduction.
منابع مشابه
Percutaneous closure of a patent foramen ovale after cryptogenic stroke
A patent foramen ovale is a common intracardiac finding that is located between the left and right atrium. It can cause right-to-left shunting and has a high prevalence in patients who suffer a cryptogenic stroke. Earlier trials did not show superiority of percutaneous patent foramen ovale closure with standard medical therapy over standard medical therapy alone in the treatment of cryptogenic ...
متن کاملPatent foramen ovale and cryptogenic stroke: the hole story.
Despite 3 recent randomized clinical trials, the management of patients with cryptogenic stroke and patent foramen ovale remains unsettled. The primary results of Evaluation of the STARFlex Septal Closure System in Patients with a Stroke and/or Transient Ischemic Attack due to Presumed Paradoxical Embolism Through a Patent Foramen Ovale (CLOSURE), Percutaneous Closure of Patent Foramen Ovale in...
متن کاملClosure of patent foramen ovale in cryptogenic stroke: a never ending story.
PURPOSE OF REVIEW This review discusses current evidence on patent foramen ovale (PFO) closure compared with medical therapy alone in the prevention of stroke recurrence in patients with a PFO-associated cryptogenic stroke. RECENT FINDINGS The Risk of Paradoxical Embolism group built a 10-point Score, based on clinical parameters, that estimates the probability of finding a PFO in a patient w...
متن کاملPatent foramen ovale closure and medical treatments for secondary stroke prevention: a systematic review of observational and randomized evidence.
BACKGROUND AND PURPOSE Patients discovered to have a patent foramen ovale in the setting of a cryptogenic stroke may be treated with percutaneous closure, antiplatelet therapy, or anticoagulants. A recent randomized trial (CLOSURE I) did not detect any benefit of closure over medical treatment alone; the optimal medical therapy is also unknown. We synthesized the available evidence on secondary...
متن کاملClosure of patent foramen ovale in "cryptogenic" stroke: Has the story come to an end?
Contrasting with three randomized trials that failed to show any superiority of patent foramen ovale closure over antithrombotic therapy, two trials recently reported lower rates of stroke recurrence among patients assigned to patent foramen ovale closure than among those assigned to antiplatelet therapy. In addition, one of the initially negative trials concluded in favor of patent foramen ova...
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عنوان ژورنال:
- Annals of internal medicine
دوره 159 4 شماره
صفحات -
تاریخ انتشار 2013