Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Stroke Vasc Neurol. 2018 Jun 26;3(2):84-91. doi: 10.1136/svn-2018-000173. eCollection 2018 Jun.
The patent foramen ovale (PFO), given its high prevalence in the general population and especially in patients with cryptogenic stroke, has long generated investigation and debate on its propensity for stroke by paradoxical embolism and its management for stroke prevention. The pendulum has swung for percutaneous PFO closure for secondary stroke prevention in cryptogenic stroke. Based on a review of current evidence, the benefit from PFO closure relies on careful patient selection: those under the age of 60 years with few to no vascular risk factors and embolic-appearing stroke deemed cryptogenic after thorough evaluation. As these data look towards influencing guideline statements and device approvals in the future, patient selection remains the crucial ingredient for clinical decision making and future trials.
卵圆孔未闭（PFO）在普通人群中发病率很高，尤其是在隐源性卒中患者中，因此长期以来，人们一直在研究和争论其通过反常栓塞引起卒中的倾向及其预防卒中的治疗方法。经皮 PFO 封堵术治疗隐源性卒中的二级预防作用也几经反复。基于对现有证据的回顾，PFO 封堵的获益依赖于仔细的患者选择：年龄在 60 岁以下、血管危险因素少或无、经过彻底评估后被认为是隐源性的栓塞性卒中患者。随着这些数据对未来指南声明和器械批准的影响，患者选择仍然是临床决策和未来试验的关键因素。
