Approaches to treatment

  • PFO associated with stroke is relatively uncommon so we lack relaible evidence about which treatment are best.
  • The risk of recurrent stroke is only about 2% per year – so RCTs need to be very large with long follow up to demonstrate that a treatment has reduced this risk significantly.
  • Aspirin (or other antiplatelet drug) – relatively safe and well tolerated.
  • Anticoagulation – likely to reduce clots but associated with significant bleeding risk and Warfarin is inconvenient. Young patients face many years of treatment.
  • Percutaneous closure of PFO – PFOs can be closed during a cardiac catheter procedure. This procedure carries risks of arhythmias, bleeding and embolism of the closure device.
  • Decisions about treatment need to take account of an individual assessment of the patients risks and take account of their beliefs and concerns.

You have reached the end of this topic loop.