Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States.
Cardiology Department, Advocate Illinois Masonic Medical Center, Chicago, IL, United States.
Handb Clin Neurol. 2021;177:43-56. doi: 10.1016/B978-0-12-819814-8.00009-3.
Approximately one-third of strokes are cryptogenic in origin. These patients have a higher prevalence of patent foramen ovale (PFO) compared to individuals with stroke of known origin. It has been proposed that some cryptogenic strokes (CSs) can be caused by paradoxical embolism across a PFO. PFOs can be treated medically with antithrombotic agents and percutaneously with occluder devices. Large randomized clinical trials have found transcatheter PFO closure to be superior to medical treatment for the prevention of recurrent stroke in young patients with CS. However, the superiority of PFO closure over medical treatment in unselected populations has not been demonstrated. In this chapter, we review the evidence supporting PFO closure and the selection of patients for such intervention.
大约三分之一的中风是隐源性的。与已知病因的中风患者相比，这些患者卵圆孔未闭（PFO）的患病率更高。有人提出，一些隐源性中风（CS）可能是由于 PFO 内的反常栓塞引起的。PFO 可以通过抗血栓药物进行内科治疗，也可以通过封堵器进行经皮治疗。大型随机临床试验发现，经导管 PFO 封堵术在预防年轻 CS 患者复发性中风方面优于内科治疗。然而，在未选择的人群中，PFO 封堵术优于内科治疗的优越性尚未得到证实。在本章中，我们回顾了支持 PFO 封堵术的证据以及对这类干预措施的患者选择。
