Patent foramen ovale and stroke: what should be done?
Patent foramen ovale and stroke: what should be done?
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DOI：
10.1097/moh.0b013e32832d47dd
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发表时间：
2009-09-01
影响因子：
3.2
通讯作者：
Homma, Shunichi
中科院分区：
文献类型：
--
作者：
Di Tullio, Marco R.;Homma, Shunichi
目的回顾近年来证实卵圆孔未闭(PFO)是缺血性卒中的危险因素。然而，预防复发的最佳治疗方案仍然存在争议，抗血栓治疗或经导管PFO封堵术受到不同临床医生的青睐。此外，可能指导治疗选择的相关条件正在调查中。最近的发现与PFO相关的中风风险，主要被认为在较年轻的患者中很重要，在55岁以上的患者中也得到了承认和更好的定义。对可能增加通过PFO进行矛盾栓塞术可能性的潜在辅助因素的研究已经取得了一些进展，有望在未来允许更多知情和合理的治疗选择。关于经导管PFO封堵术的疗效，已有更多的数据。摘要近年来，对PFO合并缺血性卒中患者的治疗方法有了更好的定义。然而，需要更好地了解增加PFO患者卒中风险的因素，以及比较药物治疗和关闭PFO的随机治疗试验的结果，以进一步推动这一领域的发展。
Purpose of reviewThe role of a patent foramen ovale (PFO) as a risk factor for ischemic stroke has been established in recent years. However, the best therapeutic option to prevent recurrent events is still controversial, with antithrombotic treatment or transcatheter PFO closure being favored by different clinicians. Also, associated conditions that may guide the therapeutic choices are being investigated.Recent findingsThe stroke risk associated with a PFO, mainly considered of importance in younger patients, has also been recognized and better defined in patients over the age of 55 years. The study of potential cofactors that may increase the possibility of paradoxical embolization through the PFO has made some progress and holds promises of allowing more informed and rational treatment choices in the future. More data have become available on the efficacy of transcatheter PFO closure.SummaryThe approach to patients with PFO and ischemic stroke has been better defined in recent years. However, a better understanding of factors that increase the stroke risk in individuals with a PFO and the results from randomized treatment trials comparing medical treatment with PFO closure are needed to further advance the field.