Köhrmann Martin, Schellinger Peter D, Tsivgoulis Georgios, Steiner Thorsten
Department of Neurology, Essen University Hospital, Essen, Germany.
Johannes Wesling Medical Center Minden, UK RUB, Minden, Germany.
J Stroke. 2019 Jan;21(1):23-30. doi: 10.5853/jos.2018.03097. Epub 2019 Jan 31.
The optimal treatment strategy for secondary prevention in patients with cryptogenic stroke and patent foramen ovale (PFO) has been a matter of controversy for decades. After three randomized trials failed to show a benefit of closure with an excess of complications in the interventional arm, two large recent trials suggest a benefit with regard of preventing further ischemic strokes. With this discrepancy in results it is important to discuss recent trials in detail and evolve an informed clinical approach for daily practice.
几十年来,隐源性卒中合并卵圆孔未闭(PFO)患者二级预防的最佳治疗策略一直存在争议。在三项随机试验未能显示介入组封堵术有获益且并发症过多之后,最近的两项大型试验表明在预防进一步缺血性卒中方面有获益。鉴于结果存在差异,详细讨论近期试验并制定切实可行的临床实践方法很重要。