Management of patients with stroke and a patent foramen ovale

被引：0
作者：
Rodriguez C.J. [1 ]
Homma S. [1 ]
机构：
[1] Department of Medicine, Columbia Univ. Coll. Phys./Surgeons, New York, NY 10032
来源：
Current Neurology and Neuroscience Reports | 2004年 / 4卷 / 1期
关键词：
Surgical Closure; Transcatheter Closure; Cryptogenic Stroke; Paradoxical Embolism; Atrial Septal Aneurysm;
D O I：
10.1007/s11910-004-0006-8
中图分类号：
学科分类号：
摘要：
Observational studies have established a strong association between the presence of patent foramen ovale (PFO) and increased risk of ischemic stroke. The mechanism involved is presumed to be a paradoxical embolism from a venous thrombus that travels via the PFO to the systemic circulation. The best treatment modality to prevent recurrent stroke in patients with PFO remains undefined. There are four major choices: 1) medical therapy with anticoagulants, 2) medical therapy with antiplatelet agents, 3) surgical closure, and 4) percutaneous device closure. The Patent Foramen Ovate in Cryptogenic Stroke Study has demonstrated that antiplatelet and anticoagulant therapies are of equal benefit in preventing recurrent neurologic events in stroke patients with a PFO. Medical therapy should remain as the initial choice of secondary prophylactic therapy. PFO closure, either surgical or percutaneous, may further reduce event rates; however, this remains to be demonstrated because no randomized trial to date has compared PFO closure with medical therapy. Copyright © 2004 by Current Science Inc.
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页码：19 / 22
页数：3
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