Stroke Clinical Trial
Official title:
The Effect of Device Closure of Patent Foramen Ovale in Elderly Patients With Crytogenic Stoke/TCI
The primary objective is to evaluate if patent foramen ovale (PFO) closure and antiplatelet medical management can reduce the risk of recurrent stroke or transient ischemic attack (TIA) when compared to antiplatelet medical management alone in elderly patients above 50 years of age with a PFO and a history of cryptogenic stroke or TIA.
Prior to birth the fetal heart has a connection between the two atrias of the heart. After
labour this connection often closes. About 10-15 % these connections remains open. This
phenomenon is called patent foramen ovale or PFO, and is in most cases unsymptomatic.
The prevalence of PFO in patients with crytogenic (without known causes) stroke is much
higher (about 40%)than the general population (about 10%). This has led to the theory that
the presence of PFO can lead to stroke, by the passage of emboli from the peripheral venous
circulation through the PFO to the brain by right-to-left shunting of the blood.
There are no existing data from prospective randomized studies focusing on the effect of
device closure PFO in patients with cryptogenic stroke. Some observational retrospective
studies have shown a beneficial effect in the reduction of recurrent stoke in patients
younger that 50 years with cryptogenic stroke when PFO has been closed with a percutaneous
device closure(PCD). Some studies have reported an 0% to 3.4% annual recurrence rate of
stroke or TIA in patients treated with PDC. The recurrence rate of stroke or TIA in patients
with crytogenic stroke or TIA in ordinary antithrombotic treatment is about 5-15 %.
The primary objective of this study is to assess whether percutaneous device closure of
patent foramen ovale is superior to conventional antithrombotic treatment in preventing
stroke recurrence in elderly patients above 50 years of age.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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