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MINI REVIEW article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1533232
This article is part of the Research Topic Cryptogenic Ischemic Stroke View all 4 articles

CRYPTOGENIC STROKE AND PATENT FORAMEN OVALE: ENDEAVORING FOR CLARITY

Provisionally accepted
Tohid Amini Tohid Amini 1,2*
  • 1 School of International Medicine, Istanbul Medipol University, Istanbul, Türkiye
  • 2 Medipol University Hospital, Bağcılar, Istanbul, Türkiye

The final, formatted version of the article will be published soon.

    This review aims to summarize current knowledge and highlight recent findings on the association between cryptogenic stroke (CS) and patent foramen ovale (PFO). By presenting sometimes conflicting data, the review underscores the necessity for further research to clarify the complex mechanisms behind PFO-related CS and optimize its management. Results from research identifies specific conditions and scores, such as the Risk of Paradoxical Embolism (RoPE) score, that help assess the likelihood of PFO-related cryptogenic stroke and guide treatment decisions. PFO closure has demonstrated substantial benefits in select cases, especially those with high-risk PFO features, though complications such as atrial fibrillation were frequently documented. Biomarker measurements, such as reduced total homocysteine (tHcy) level after PFO closure or high D-dimer levels indicating a higher risk of stroke recurrence, represent newer areas of study with a promising future in medical practice. Cryptogenic stroke (CS) remains a diagnostic challenge. This article reviews the current understanding of PFO-related CS, focusing on the interplay of concomitant pathological conditions, PFO closure, stroke recurrence, and some of the related biomarkers.1. High RoPE Score (≥7): This patient scores 10 on the RoPE scale which fulfills this criteria.2. High-Risk PFO Features: TEE revealed a marked right-to-left shunt through the PFO. This anatomical characteristic is classified as high-risk.The PASCAL classification indicates a strong likelihood that the PFO contributed to the stroke. Table 1. RoPE score components (by Kent et al. (10))

    Keywords: cryptogenic stroke (CS), PFO (patent foramen ovale), PFO closure, Stroke recurrence, biomarkers, Perioperative stroke, RoPE score and PASCAL classification, PFO detection

    Received: 23 Nov 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Amini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tohid Amini, School of International Medicine, Istanbul Medipol University, Istanbul, Türkiye

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