Patent foramen ovale closure. Pro and cons

Eustaquio Onorato, Francesco Casilli, Marco Berti, Gian Paolo Anzola

Research output: Contribution to journalArticle

Abstract

Because patent foramen ovale (PFO) represents a lesion which may be repaired a number of expert clinicians believe that mechanical closure should be the primary treatment modality for patients with PFO after cryptogenic stroke; interest has grown on percutaneous devices and in the last years there has been great technological advancement of percutaneous techniques for PFO closure. However, we should not close a PFO before establishing the evidence-based indications. At the same time, efforts to develop safer and more effective closure devices are under way. These devices include those with little or no metal component and those with biodegradable discs. Ideally, we should be able to identify at-risk patients before they sustain a stroke and to prevent stroke by closing the PFO with a device that should result in complete closure, be made of material that conforms to both sides of the septum, and have no risk of erosion, infection, arrhythmia, or thrombogenicity. Randomised trials comparing medical and percutaneous closure approaches are underway, but large patient enrollment is necessary because of the low event rate in the younger patients. Meanwhile, as the complication rate from device implantation decreases and simpler devices are developed with reliability further demonstrated, the threshold for percutaneous closure is likely to decline.

Original languageEnglish
JournalNeurological Sciences
Volume29
Issue numberSUPPL. 1
DOIs
Publication statusPublished - May 2008

Fingerprint

Patent Foramen Ovale
Equipment and Supplies
Stroke
Cardiac Arrhythmias
Metals
Infection

Keywords

  • Atrial septal aneurysm
  • Paradoxical embolism
  • Patent foramen ovale
  • Percutaneous closure
  • Right-to-left shunt

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Onorato, E., Casilli, F., Berti, M., & Anzola, G. P. (2008). Patent foramen ovale closure. Pro and cons. Neurological Sciences, 29(SUPPL. 1). https://doi.org/10.1007/s10072-008-0881-x

Patent foramen ovale closure. Pro and cons. / Onorato, Eustaquio; Casilli, Francesco; Berti, Marco; Anzola, Gian Paolo.

In: Neurological Sciences, Vol. 29, No. SUPPL. 1, 05.2008.

Research output: Contribution to journalArticle

Onorato, E, Casilli, F, Berti, M & Anzola, GP 2008, 'Patent foramen ovale closure. Pro and cons', Neurological Sciences, vol. 29, no. SUPPL. 1. https://doi.org/10.1007/s10072-008-0881-x
Onorato, Eustaquio ; Casilli, Francesco ; Berti, Marco ; Anzola, Gian Paolo. / Patent foramen ovale closure. Pro and cons. In: Neurological Sciences. 2008 ; Vol. 29, No. SUPPL. 1.
@article{896a265129b84d19a995532fd8ce76bb,
title = "Patent foramen ovale closure. Pro and cons",
abstract = "Because patent foramen ovale (PFO) represents a lesion which may be repaired a number of expert clinicians believe that mechanical closure should be the primary treatment modality for patients with PFO after cryptogenic stroke; interest has grown on percutaneous devices and in the last years there has been great technological advancement of percutaneous techniques for PFO closure. However, we should not close a PFO before establishing the evidence-based indications. At the same time, efforts to develop safer and more effective closure devices are under way. These devices include those with little or no metal component and those with biodegradable discs. Ideally, we should be able to identify at-risk patients before they sustain a stroke and to prevent stroke by closing the PFO with a device that should result in complete closure, be made of material that conforms to both sides of the septum, and have no risk of erosion, infection, arrhythmia, or thrombogenicity. Randomised trials comparing medical and percutaneous closure approaches are underway, but large patient enrollment is necessary because of the low event rate in the younger patients. Meanwhile, as the complication rate from device implantation decreases and simpler devices are developed with reliability further demonstrated, the threshold for percutaneous closure is likely to decline.",
keywords = "Atrial septal aneurysm, Paradoxical embolism, Patent foramen ovale, Percutaneous closure, Right-to-left shunt",
author = "Eustaquio Onorato and Francesco Casilli and Marco Berti and Anzola, {Gian Paolo}",
year = "2008",
month = "5",
doi = "10.1007/s10072-008-0881-x",
language = "English",
volume = "29",
journal = "Neurological Sciences",
issn = "1590-1874",
publisher = "Springer-Verlag Italia s.r.l.",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Patent foramen ovale closure. Pro and cons

AU - Onorato, Eustaquio

AU - Casilli, Francesco

AU - Berti, Marco

AU - Anzola, Gian Paolo

PY - 2008/5

Y1 - 2008/5

N2 - Because patent foramen ovale (PFO) represents a lesion which may be repaired a number of expert clinicians believe that mechanical closure should be the primary treatment modality for patients with PFO after cryptogenic stroke; interest has grown on percutaneous devices and in the last years there has been great technological advancement of percutaneous techniques for PFO closure. However, we should not close a PFO before establishing the evidence-based indications. At the same time, efforts to develop safer and more effective closure devices are under way. These devices include those with little or no metal component and those with biodegradable discs. Ideally, we should be able to identify at-risk patients before they sustain a stroke and to prevent stroke by closing the PFO with a device that should result in complete closure, be made of material that conforms to both sides of the septum, and have no risk of erosion, infection, arrhythmia, or thrombogenicity. Randomised trials comparing medical and percutaneous closure approaches are underway, but large patient enrollment is necessary because of the low event rate in the younger patients. Meanwhile, as the complication rate from device implantation decreases and simpler devices are developed with reliability further demonstrated, the threshold for percutaneous closure is likely to decline.

AB - Because patent foramen ovale (PFO) represents a lesion which may be repaired a number of expert clinicians believe that mechanical closure should be the primary treatment modality for patients with PFO after cryptogenic stroke; interest has grown on percutaneous devices and in the last years there has been great technological advancement of percutaneous techniques for PFO closure. However, we should not close a PFO before establishing the evidence-based indications. At the same time, efforts to develop safer and more effective closure devices are under way. These devices include those with little or no metal component and those with biodegradable discs. Ideally, we should be able to identify at-risk patients before they sustain a stroke and to prevent stroke by closing the PFO with a device that should result in complete closure, be made of material that conforms to both sides of the septum, and have no risk of erosion, infection, arrhythmia, or thrombogenicity. Randomised trials comparing medical and percutaneous closure approaches are underway, but large patient enrollment is necessary because of the low event rate in the younger patients. Meanwhile, as the complication rate from device implantation decreases and simpler devices are developed with reliability further demonstrated, the threshold for percutaneous closure is likely to decline.

KW - Atrial septal aneurysm

KW - Paradoxical embolism

KW - Patent foramen ovale

KW - Percutaneous closure

KW - Right-to-left shunt

UR - http://www.scopus.com/inward/record.url?scp=45449088405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=45449088405&partnerID=8YFLogxK

U2 - 10.1007/s10072-008-0881-x

DO - 10.1007/s10072-008-0881-x

M3 - Article

VL - 29

JO - Neurological Sciences

JF - Neurological Sciences

SN - 1590-1874

IS - SUPPL. 1

ER -