Patent Foramen Ovale Treatment Strategies Correspond to an Index Predicting Pathogenicity

• Published in: Curēus (Palo Alto, CA) CA), 2019-05, Vol.11 (5), p.e4778-e4778
• Main Authors: Parr, Christopher, Liu, Shuangbo, Perija, Brittany, Shaikh, Nasir, Kass, Malek
• Format: Article
• Language: English
• Subjects: Cardiology; Diabetes; Hypertension; Medical imaging; Neurology; NMR; Nuclear magnetic resonance; Patients; Stroke; Success; Ultrasonic imaging; Variables
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.4778

Percutaneous closure of patent foramen ovale (PFO) in patients with cryptogenic stroke (CS) may reduce the risk of recurrent stroke. By performing closure only in those with high risk of recurrent PFO related strokes, patient selection may be improved. The Risk of Paradoxical Embolism (RoPE) score is a point-based index developed to estimate the probability that the index CS was attributable to patent foramen ovale. We aimed to evaluate whether management strategies using conventional clinical judgement for patients with CS and PFO corresponded with RoPE scores. We performed a single-centre retrospective chart review of adult patients with CS or transient ischemic attack who were evaluated for PFO closure from January 1, 2011 to December 31, 2017. Patients were categorized based on the treatment strategy of percutaneous closure or medical management. RoPE scores were computed and clinical outcomes evaluated. A total of 154 patients were included: 63 patients underwent percutaneous closure and 91 patients were treated medically. Mean RoPE scores for closure and medical groups were 6.9±1.5 and 4.7±1.9, respectively (p