Editorial
Should percutaneous devices be used to close a patent foramen ovale after cerebral infarction or TIA?
| The first 150 words of the full text of this article appear below. |
Approximately one third of the population has a patent foramen ovale (PFO); about the same frequency as having brown hair. Can a normal finding be important in the cause of stroke, and should it change management? In particular should we close a normal hole with an artificial device?
The incidence of PFO in patients with cerebral infarction is about
20-30%, which is similar to that in control
subjects.1 2 This has been taken to imply that PFO is
coincidental.2 However, the incidence of PFO is usually
higher, about 50-60%,3 in cryptogenic cerebral infarcts
(those associated with normal carotid ultrasonography and
haematological analysis in patients with no atrial fibrillation or
other clinical evidence of heart disease). Furthermore, PFOs in
patients with cryptogenic stroke are larger than in patients with
another potential cause for stroke4 and in control
subjects.5 Finally, the recurrence rate of cryptogenic
stroke is higher if a PFO is detected
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