Different Strokes
Authors: William G. Kussmaul
Journal: Annals of Internal Medicine (2020)

Editorials2 June 2020Different StrokesWilliam G. Kussmaul III, MDWilliam G. Kussmaul III, MDMedia, Pennsylvania (W.G.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-1879 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The year 2020 will be memorable for many reasons, with public health concerns center stage, along with resulting massive alterations in community lifestyles. Yet for individual patients, few events are as life changing as stroke. In recent months, there have been new developments worth noting for one group of stroke patients and their physicians, as highlighted in Annals.Patent foramen ovale (PFO) is now recognized among the causes of stroke. The mechanism is presumed to involve venous thromboemboli crossing from right to left. The ability to close these congenital atrial septal openings without open-heart surgery has existed for years, but ...References1. Messé SR, Kent DM. Still no closure on the question of PFO closure [Editorial]. N Engl J Med. 2013;368:1152-3. [PMID: 23514293] doi:10.1056/NEJMe1301680 CrossrefMedlineGoogle Scholar2. Favilla CG, Messé SR. Patent foramen ovale and stroke: current evidence and treatment options. Curr Opin Neurol. 2020;33:10-16. [PMID: 31789709] doi:10.1097/WCO.0000000000000782 CrossrefMedlineGoogle Scholar3. Deng W, Yin S, McMullin D, et al. Residual shunt after patent foramen ovale closure and long-term stroke recurrence. A prospective cohort study. Ann Intern Med. 2020;172:717-25. doi:10.7326/M19-3583 LinkGoogle Scholar4. Shah AH, Osten M, Benson L, et al. Incidence and outcomes of positive bubble contrast study results after transcatheter closure of a patent foramen ovale. JACC Cardiovasc Interv. 2018;11:1095-1104. [PMID: 29880106] doi:10.1016/j.jcin.2018.03.008 CrossrefMedlineGoogle Scholar5. Bushnell C, Goldstein LB. Screening for hypercoagulable syndromes following stroke. Curr Atheroscler Rep. 2003;5:291-8. [PMID: 12793970] CrossrefMedlineGoogle Scholar6. Lee PH, Song JK, Kim JS, et al. Cryptogenic stroke and high-risk patent foramen ovale: the DEFENSE-PFO trial. J Am Coll Cardiol. 2018;71:2335-2342. [PMID: 29544871] doi:10.1016/j.jacc.2018.02.046 CrossrefMedlineGoogle Scholar7. Wintzer-Wehekind J, Alperi A, Houde C, et al. Long-term follow-up after closure of patent foramen ovale in patients with cryptogenic embolism. J Am Coll Cardiol. 2019;73:278-287. [PMID: 30678757] doi:10.1016/j.jacc.2018.10.061 CrossrefMedlineGoogle Scholar8. Leppert MH, Poisson SN, Carroll JD, et al. Cost-effectiveness of patent foramen ovale closure versus medical therapy for secondary stroke prevention. Stroke. 2018;49:1443-1450. [PMID: 29720435] doi:10.1161/STROKEAHA.117.020322 CrossrefMedlineGoogle Scholar9. Ben-Assa E, Rengifo-Moreno P, Al-Bawardy R, et al. Effect of residual interatrial shunt on migraine burden after transcatheter closure of patent foramen ovale. JACC Cardiovasc Interv. 2020;13:293-302. [PMID: 32029246] doi:10.1016/j.jcin.2019.09.042 CrossrefMedlineGoogle Scholar10. Le Moigne E, Timsit S, Ben Salem D, et al. Patent foramen ovale and ischemic stroke in patients with pulmonary embolism: a prospective cohort study. Ann Intern Med. 2019;170:756-763. [PMID: 31060047]. doi:10.7326/M18-3485 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Media, Pennsylvania (W.G.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-1879.Corresponding Author: William G. Kussmaul III, MD, 1343 West Baltimore Pike, E-401, Media, PA 19063; e-mail, w.[email protected]net.This article was published at Annals.org on 12 May 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResidual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence Wenjun Deng , Shanye Yin , David McMullin , Ignacio Inglessis-Azuaje , Sammy Elmariah , Judy Hung , Eng H. Lo , Igor F. Palacios , Ferdinando S. Buonanno , and MingMing Ning Metrics 2 June 2020Volume 172, Issue 11Page: 761-762KeywordsDisclosureIschemic strokePatient advocacyPrevention, policy, and public healthPulmonary embolismRisk managementSafetyStrokeSurgeryTransient ischemic attacks ePublished: 12 May 2020 Issue Published: 2 June 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...