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.
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