The purpose of this study is to compare two treatments strategies to prevent further attacks in patients who have suffered an stroke or occlusion of a major artery with no obvious reason other than a persistent small opening between the upper heart chambers
In patients who have suffered a stroke or occlusion of a large artery in another body part of unknown origin a possible cause is a small opening between the upper heart chambers (patent foramen ovale, it is called). After birth this opening closes in 75% of the population, while it persists in 25% of people. It may allow a small blood clot to pass from the veins of the legs through the heart into the brain or other parts of the body. In order to reduce the risk for a further attack we have today more therapeutic options to choose from but it is unclear which strategy have the best outcome. This study is created to compare the effect of two treatment strategies: 1. Medical treatment The purpose of medical treatment is to dilute the blood to a degree, that no thrombus formation occurs. Since the opening in the heart persists, treatment is usually recommended lifelong. And patients treated with coumadin must undergo regular blood tests to ensure an adequate effect of the drug. 2. Catheter closure of patent foramen ovale An alternative method developed to close the small opening in the heart utilizes catheters which are introduced in a blood vessel in the groin and from there advanced to the heart. An umbrella device is then delivered through the catheter, positioned within the small defect and released. The umbrella is overgrown with own tissue within weeks to months and closes the small defect for ever.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
414
Percutaneous implantation of an AMPLATZER® PFO Occluder
Investigator's choice: Anticoagulation to INR 2.0 - 3.0 OR Aspirin 100-325 mg/d OR Clopidogrel 75-150 mg/d
Monash Medical Centre
Melbourne, Australia
Sir Charles Gairdner Hospital
Nedlands, Australia
Alfred Hospital
Prahan, Australia
Universitätsklinik für Innere Medizin II
Vienna, Austria
Time to death (Fatal stroke, cardiovascular, non-CV),
Time frame: continuosly
non-fatal cerebrovascular event,
Time frame: continuosly
peripheral embolism
Time frame: continuosly
New arrhythmias,
Time frame: continuosly
myocardial infarction
Time frame: continuosly
rehospitalization related to PFO or its treatment
Time frame: continuosly
device problems
Time frame: continuosly
bleeding complications
Time frame: continuosly
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
A.Z. Sint-Jan AV
Bruges, Belgium
University Hospital / Inselspital
Bern, Switzerland