Patent foramen ovale (PFO) is a recognized cause of cryptogenic stroke, and its closure via percutaneous treatment has been shown to be effective compared to medical therapy, according to several randomized studies with follow-ups of up to 5 and even 10 years. However, beyond this period, available data are limited.
Using the PROLONG registry, researchers conducted an analysis that included 1245 patients who underwent percutaneous PFO closure after experiencing cryptogenic ischemic stroke, transient ischemic attack (TIA), systemic embolism, or silent ischemic lesions detected by magnetic resonance imaging.
Mean patient age was 47 years; 56% of subjects were women. Hypertension was present in 22% of cases, diabetes in 3.1%, smoking in 14%, a history of deep vein thrombosis or pulmonary embolism in 4.7%, and migraine in 32%.
The average RoPE score was 6.2, and 42% of the cases were classified as “probable” according to the PASCAL category.
The most frequent indication for PFO closure was TIA (52%), followed by ischemic stroke (36%), and to a lesser extent by silent ischemic lesions and systemic embolism.
The procedure was successful in 99.1% of cases. There were no instances of in-hospital death, stroke, or cardiac tamponade reported.
Read also: Post-TAVR Pacemaker Implantation in Aortic Regurgitation.
The follow-up period was 14.5 years. During this time, mortality was 4.7%; the composite event of stroke, TIA, or systemic embolism occurred in 2.7% of cases, stroke in 1.4%, severe bleeding in 0.4%, and new-onset atrial fibrillation in 4.2%. Residual shunting was mild in 8.1%, moderate in 0.9%, and severe in 0.1% of cases.
Predictors of recurrent events included the presence of atrial fibrillation, a RoPE score ≤7, and a non-probable PASCAL category.
Conclusion
This study confirms the effectiveness and safety of percutaneous patent foramen ovale closure in patients with cryptogenic embolism in a real-world setting.
Original Title: 15-Year Outcomes of PFO Closure in Patients With Cryptogenic Embolism Insights From the PROLONG Registry.
Reference: Carlo Gaspardone, et al. JACC Cardiovasc Interv. 2025;18:1526–1537.
Subscribe to our weekly newsletter
Get the latest scientific articles on interventional cardiology
 es una causa reconocida de stroke criptogénico, y su cierre mediante tratamiento percutáneo ha demostrado ser efectivo en comparación con el tratamiento médico.){kind=link}