Cryptogenic stroke patient's pathway and the qualification process for a patent foramen ovale closure: Experiences of the NeuroHeart Team.

BACKGROUND

Nearly half of all patients with cryptogenic stroke (CS) have a patent foramen ovale (PFO). Percutaneous PFO closure is a well-established method for secondary prevention of CS and should be considered for individuals with the highest likelihood of a causal link between PFO and stroke.

AIMS

The study aimed to describe the qualification process and analyze the profiles of patients eligible for PFO closure as a secondary prevention strategy for CS.

MATERIAL AND METHODS

This study involved a retrospective review of the medical records of patients who were assessed for PFO closure by the NeuroHeart Team. A total of 276 patients were included in the study. Of these, 132 patients (47.8%) were found to be eligible for PFO closure. Key determinants of patient eligibility for the procedure were identified based on a range of demographic, clinical, neuroimaging, and echocardiographic factors.

RESULTS

Qualified patients were less likely to be female (52.3% vs. 77.1%; P <0.001), had a higher incidence of acute cerebral ischemia - stroke or transient ischemic attack (P <0.001), were more frequently hospitalized for stroke/transient ischemic attack (82.6% vs. 29.9%; P <0.001), and were less likely to have non-ischemic central nervous system changes (12.9% vs. 50%; P <0.001). Additionally, qualified patients had lower comorbidity as expressed in Charlson's Comorbidity Index and achieved higher scores on the Risk of Paradoxical Embolism scale.

CONCLUSIONS

During the qualification process for PFO closure, a patient's clinical profile should be thoroughly assessed, with careful consideration of the procedure's benefits and risks in line with current recommendations from scientific societies.