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J Stroke. 2015 Sep;17(3):229-237. English. Review. https://doi.org/10.5853/jos.2015.17.3.229
Bang OY , Lee MJ , Ryoo S , Kim SJ , Kim JW .
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ohyoung.bang@samsung.com
Department of Neurology, National Medical Center, Seoul, Korea.
Abstract

Patent foramen ovale (PFO) is growing in clinical interest because of a renewed focus on embolic stroke of undetermined source (ESUS), the PFO attributable fraction (the 10-point Risk of Paradoxical Embolism score), technical advances in PFO diagnosis, and the emergence of endovascular device closure as a treatment option. However, recent randomized controlled trials of the management of patients with ESUS and PFO failed to demonstrate the superiority of closure over medical treatment. The mechanisms of stroke other than paradoxical embolism may be important in patients with ESUS and PFO. This paper reviews the current understanding of the pathophysiology of stroke and therapeutic options in patients with PFO and ESUS.

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