Ischemic attacks and patent foramen ovale: Transcatheter closure of patentforamen ovale in adults with cryptogenic systemic embolism

In the presence of a parent foramen ovale with otherwise unexplained (crypt ogenic) cerebral embolism, the usual therapy is oral anticoagulation or ant iplatelet therapy. Surgery, is considered only in cases of recurrence. Perc utaneous transcatheter occlusion of the patent foramen ovale (PFO) is a new valuable alternative. This article presents the current knowledge and our data concerning nonsurgical closure of patent foramen ovale to prevent para doxical arterial embolism. Transcatheter PFO closure represents an elegant therapeutic approach in patients with suspected paradoxical embolism becaus e it avoids open heart surgery and is minimally invasive. Even if the recur rence rate of embolism were identical, transcatheter closure would be prefe rable to anticoagulation because the annual risk of bleeding complications of 2%-3% and the long-term casts of anticoagulation can be avoided. Randomi zed studies are needed to compare transcatheter closure of patent foramen o vale with anticoagulation, platelet inhibitors, or surgery.