Naslov
Patent foramen ovale - how to treate?

Autori
Tuškan-Mohar, Lidija

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Neurologia Croatica 2014, 63(Supl 1):1-44 / Hajnšek, Sanja ; Petravić, Damir ; Poljaković, Zdravka - Zagreb, 2014, 24-24

Skup
4. hrvatski kongres:"Dileme u neurologiji" 3. hrvatski kongres iz intenzivne neurologije

Mjesto i datum
Rovinj, Hrvatska, 30.09.2014. - 05.10.2014

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
patent foramen ovale; tretament
(patent foramen ovale; treatment)

Sažetak
The patent foramen ovale (PFO) is an interatrial communication with the potential for right-to-left shunt, therefore representing a potential route for embolic transit of platelet aggregates, thrombi, gas bubbles, or other particulate matter from the systemic venous circulation to the brain. A statistically significant association between PFO and cryptogenic stroke has been reported in several case-control studies. The recurrence rate of stroke or TIA has been reported to be as high as 3.4-3.9% per year. However, several studies have consistently found that the presence of a PFO does not increase the risk of recurrent stroke. Among general population the prevalence of PFO is about 20%, and it may be as high as 56% in patients younger than 55 years of age who have a cryptogenic stroke. The optimal approach to secondary prevention in patients with PFO and history of cryptogenic stroke has not yet been established and still remains uncertain and controversial. Crucial question is what to do to prevent another episode? At present, treatment options include the medical therapy with the antipletelet agents or anticoagulants, transcatheter PFO closure and open surgical repair. The role of PFO as a stroke risk factor in the general population has not been confirmed. So, no preventive treatment is therefore necessary in the individuals with an incidentally detected PFO. The transcatheter device closure is superior to the medical therapy in the recurrent stroke or TIA prevention according to the conclusion of several meta-analyses. However, in the large, multicenter trial CLOSURE I was found no significant differences between closure with a percutaneous device plus the antipletelet therapy and the medical therapy alone with respect to the prevention of recurrent stroke or TIA. In grate prospective, multicenter, randomized trial RESPECT the conclusion is that the closure was superior to the medical therapy alone in the prespecified per-protocol and as-treated analysis, with a low rate of associated risks. Given the limited and conflicting data existing in the literature more randomized controlled trials are needed for further investigate regarding this issue.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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