Kitsios GD et al. – The negative findings do not lend support to using the presence of clinical indicators of paradoxical embolism as an indication for percutaneous patent foramen ovale (PFO) closure. Factors that support a paradoxical embolism mechanism may be different from those that predict paradoxical embolism recurrence.Methods
- Data from the prospective Tufts PFO Registry collected at the time of the index CS were analyzed.
- The authors defined the following radiologic markers of stroke recurrence:
- Strokes of different radiologic ages
- Silent strokes (detected on MRI but without symptoms preceding the index event).
- They examined the association between the radiologic endpoints and the clinical indicators of paradoxical embolism with multivariate logistic regression models, adjusting for age and gender.
- Data were available for 224 subjects.
- Strokes of different radiologic ages were not associated with the thrombosis-predisposing conditions (1.2 [95% confidence interval 0.5–2.7]), the Valsalva maneuver (1.3 [0.6–3.1]), or the presence of either of these factors.
- No statistically significant association was found in subgroups stratified by anatomic location of the index stroke or for the outcome of silent strokes.