Assessment of clinical outcomes after percutaneous patent foramen ovale closure in adult patients diagnosed with cryptogenic stroke

INTRODUCTION: Our study aims to report the findings of transesophageal echocardiography (TEE), Risk of Paradoxical Embolism (RoPE) score, the Patent Foramen Ovale -Associated Stroke Causal Likelihood (PASCAL) classification analyses, and follow-up results after percutaneous PFO closure in patients diagnosed with cryptogenic stroke.
METHODS: The medical records of patients with acute arterial ischemic stroke who were diagnosed with PFO by TEE and applied percutaneous PFO closure between 2020-2023 were reviewed. The echocardiography (Echo) score, the RoPE score, and the PASCAL classification were calculated for all patients as indicated in the literature. Newly developed arrhythmia, recurrent stroke, and cardiovascular death were recorded during follow-up.
RESULTS: A total of 65 patients were included in the study. The median age was 41 years [range: 33-47]), the median RoPE score was 8, and the Echo score was 3. While 29.2% of the patients were in the possible group according to the PASCAL classification, 70.8% were in the probable group. We did not have any patients in the unlikely group. Recurrent ischemic stroke was detected in only two patients at a median follow-up of 12.1 months. No cardiac arrhythmia or cardiovascular death was observed.
DISCUSSION AND CONCLUSION: PFO closure in PFO-associated stroke patients was safe, with a low incidence of arrhythmia and cardiovascular and cerebrovascular events during the short-term follow-up.