Abstract Number: Esoc2026a2486 Management Strategies and Stroke Recurrence in Patients With Patent Foramen Ovale and Concomitant Thrombophilia
Year: 2026
Type: conference-abstract
Abstract: Background and aims Patent foramen ovale (PFO) is an important cause of stroke in young patients. Percutaneous PFO closure is recommended for PFO-related stroke and commonly followed by antiplatelet therapy. Concurrent thrombophilia increases risk of venous/arterial thrombus, generally requiring long-term anticoagulation, questioning the clinical benefit of PFO closure in these cases. The best management of this “triple pathology” is still unknown. This study aims to evaluate long-term outcomes of different approaches in PFO-associated stroke patients with concurrent thrombophilia. Methods We conducted a single-center historical cohort study of PFO-associated stroke and concurrent thrombophilia. Major thrombophilias included factor V Leiden mutations, prothrombin G20210A mutations, antithrombin or protein S deficiencies, and antiphospholipid antibody syndrome. The primary outcome was recurrent stroke during follow-up. Results We included 60 patients, mean age 47.2 years (SD: 10.2), mean follow-up time 6.8 years (SD: 4.1). Patients managed with anticoagulation alone (n=21) or with PFO closure followed by anticoagulation (n=10) had no recurrent stroke (median follow-up of 7 years). In patients who closed PFO followed by antiplatelets (n=29), 17% had recurrent PFO-associated stroke, representing an annual stroke rate of 3.7%/year. Recurrent strokes took place 1-8 years after closure (median follow-up of 5 years). Conclusions This study confirms the safety of PFO closure in patients with concomitant thrombophilia and underscores the clinical importance of long-term anticoagulation in reducing the risk of recurrent vascular events. This highlights the importance of evaluating potential thrombophilias in all patients with PFO-related stroke and emphasizes the need for multidisciplinary discussion and individualized management before and after intervention. Conflict of interest All authors: nothing to disclose
Source: European Stroke Journal
Institutions: Unidade Local de Saúde de Coimbra, University of Coimbra
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160449216
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