New guidelines on the diagnosis and management of PFO after stroke

Valeria Caso, MD, PhD, FESO, from Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy, discusses the new European Stroke Organisation (ESO) guidelines on the diagnosis and management of patent foramen ovale (PFO) after stroke. The new guidelines, reflecting the updated state of knowledge in the field, cover diagnosis, treatment, and long-term management of PFO. Based on current evidence, no recommendation on the optimal diagnostic tool could be given. Prof. Caso highlights the need for further research into esophageal dopplers and transesophageal echocardiograms to determine which is optimal for PFO. For patients aged 18-60 with a stroke, PFO closure is strongly recommended. PASCAL scores can be utilized to select such candidates. For long-term atrial fibrillation monitoring, the value of implantable loop recorders remains uncertain. Evidence also implies that double antiplatelet therapy for 1-6 months, followed by 5 years of single anticoagulant therapy is beneficial. This interview was conducted at the 10th European Stroke Organisation Conference (ESOC) 2024 in Basel, Switzerland.
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