The following is the summary of “Transcatheter Patent Foramen Ovale Closure in Patients With Transient Ischemic Attack” published in the January 2023 issue of Cardiovascular Disease by Pasos, et al.

Transient ischemic attack (TIA) patients with patent foramen ovale (PFO) closure are poorly studied. The purpose of this research was to examine transcatheter PFO closure for TIA patients and to learn more about their clinical and procedural characteristics and long-term outcomes. Consecutive patients who had suffered a stroke or other cerebrovascular event and subsequently received PFO closure numbered 1,012. Patients were classified into 2 groups, one experiencing TIA (n=183 [18%]) and the other experiencing a stroke (n = 829 [82%]), the index event resulting in PFO closure.

Most patients (98%) were followed for a full three years, ranging from two to 8 years. Except for a lower Risk of Paradoxical Embolism score in the TIA group (6.1 vs. 6.9 in the stroke group, P<0.001), patients with TIA and stroke were similar. All patients could have their PFOs closed, and there was an extremely low risk of problems (1%) across the board. Long-term follow-up revealed no significant differences in the occurrence of neurologic episodes. One TIA patient experienced a stroke, while 6 stroke patients experienced strokes (0.08 vs. 0.17 per 100 patients-years, P=0.584). 2 cases of TIA were seen in the TIA group, while ten cases were seen in the stroke group (0.17 vs. 0.28 per 100 patients-years, P=0.557). 

Finally, their study demonstrated that TIA patients who underwent PFO closure shared several clinical characteristics with stroke patients, including a high Risk of Paradoxical Embolism score. These findings imply that the procedural results and long-term clinical outcomes following PFO closure are comparable to those following stroke, with a negligible frequency of recurrent neurologic episodes. However, more randomized, prospective clinical trials with this group need to be conducted.

Source: sciencedirect.com/science/article/abs/pii/S0002914922011365