Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke.

Elgendy, Akram Y; Saver, Jeffrey L; Amin, Zahid; Boudoulas, Konstantinos Dean; Carroll, John D; Elgendy, Islam Y; Grunwald, Iris Q; Gertz, Zachary M; Hijazi, Ziyad M; Horlick, Eric M; Kasner, Scott E; Kent, David M; Kumar, Preetham; Kavinsky, Clifford J; Liebeskind, David S; Lutsep, Helmi; Mojadidi, Mohammad K; Messé, Steven R; Mas, Jean-Louis; Mattle, Heinrich P.; ... (2020). Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke. JAMA neurology, 77(7), pp. 878-886. American Medical Association 10.1001/jamaneurol.2020.0458

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Importance

Recent epidemiologic and therapeutic advances have transformed understanding of the role of and therapeutic approach to patent foramen ovale (PFO) in ischemic stroke. Patent foramen ovale is likely responsible for approximately 5% of all ischemic strokes and 10% of those occurring in young and middle-aged adults.

Observations

Randomized clinical trials have demonstrated that, to prevent recurrent ischemic stroke in patients with PFO and an otherwise-cryptogenic index ischemic stroke, PFO closure is superior to antiplatelet medical therapy alone; these trials have provided some evidence that, among medical therapy options, anticoagulants may be more effective than antiplatelet agents.

Conclusions and Relevance

These new data indicate a need to update classification schemes of causative mechanisms in stroke, developed in an era in which an association between PFO and stroke was viewed as uncertain. We propose a revised general nomenclature and classification framework for PFO-associated stroke and detailed revisions for the 3 major stroke subtyping algorithms in wide use.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Mattle, Heinrich and Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2168-6157

Publisher:

American Medical Association

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

16 Jul 2020 09:55

Last Modified:

11 Sep 2020 01:33

Publisher DOI:

10.1001/jamaneurol.2020.0458

PubMed ID:

32282016

BORIS DOI:

10.7892/boris.145195

URI:

https://boris.unibe.ch/id/eprint/145195

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