{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T12:17:15Z","timestamp":1762604235473,"version":"3.37.3"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"German Research Council"},{"name":"German Ministry of Education and Research"},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bertelsmann Foundation"},{"DOI":"10.13039\/501100018867","name":"Heinz-Nixdorf Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018867","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims\u2003<\/jats:title>\n                  <jats:p>The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey to evaluate the current practice for the assessment and management of patients with suspected patent foramen ovale (PFO) and cryptogenic stroke.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results\u2003<\/jats:title>\n                  <jats:p>In total, 79 imaging centres from 34 countries across the world responded to the survey, which comprised 17 questions. Most non-invasive investigations for PFO were widely available in the responding centres, with the exception of transcranial colour Doppler which was only available in 70% of sites, and most commonly performed by neurologists. Standard transthoracic echocardiography, with or without bubbles, was considered the first-level test for suspected PFO in the majority of the centres, whereas transoesophageal echocardiography was an excellent second-level modality. Most centres would rule out atrial fibrillation (AF) as a source of embolism in all patients with cryptogenic stroke (63%), with the remainder reserving investigation for patients with multiple AF risk factors (33%). Cardiac magnetic resonance was the preferred tool for identifying other unusual aetiologies, like cardiac masses or thrombi. After PFO closure, there was variation in the use of antiplatelet therapy: a quarter recommended treatment for life, while only 12% recommended 5\u2009years as stipulated in the guidelines (12%). Antibiotic prophylaxis prior to dental or endoscopic procedures was not recommended in 41% of centres, contrary to what the guidelines recommended.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>Our survey revealed a variable adherence to the current recommendations for the diagnosis and management of patients with cryptogenic stroke and PFO. Efforts should focus on optimizing and standardizing diagnostic tests and treatment of this condition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa318","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T04:24:21Z","timestamp":1604636661000},"page":"135-141","source":"Crossref","is-referenced-by-count":14,"title":["EACVI survey on the management of patients with patent foramen ovale and cryptogenic stroke"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-9145","authenticated-orcid":false,"given":"Antonello","family":"D'Andrea","sequence":"first","affiliation":[{"name":"Department of Cardiology, Umberto I_ Hospital, Luigi Vanvitelli University - Nocera Inferiore (ASL Salerno), Viale San Francesco - 84014 Caserta, Italy"}]},{"given":"Marc R","family":"Dweck","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, Department of Cardiology, University of Edinburgh, Edinburgh, EH16 4SB, UK"}]},{"given":"Espen","family":"Holte","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Olavs Hospital, Postboks 3250 Torgarden, 7006 Trondheim, Norway"},{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology NTNU, Trondheim, PO Box 8905, 7491 Trondheim, Norway"}]},{"given":"Ricardo","family":"Fontes-Carvalho","sequence":"additional","affiliation":[{"name":"Cardiovascular Research and Development Unit, Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Al. Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci 16, 53100 Siena, Italy"}]},{"given":"Hatem Soliman","family":"Aboumarie","sequence":"additional","affiliation":[{"name":"Department of Cardiology - Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, UB9 6JH London, UK"}]},{"given":"Hans Christoph","family":"Diener","sequence":"additional","affiliation":[{"name":"Department of Neurology - Medical Faculty of the University Duisburg-Essen\u2014Institute for Medical Informatics, Biometry and Epidemiology, Hufelandstra\u00dfe, 26, 45147 Essen, Germany"}]},{"given":"Kristina H","family":"Haugaa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Postboks 4950 Nydalen, 0424 Oslo, Norway"},{"name":"Department of Cardiology - Institute for Clinical Medicine, University of Oslo, Postboks 1171 Blindern, 0318 Oslo, Norway"}]}],"member":"286","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"2021012217495306900_jeaa318-B1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0025-6196(12)60336-X","article-title":"Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts","volume":"59","author":"Hagen","year":"1984","journal-title":"Mayo Clin Proc"},{"key":"2021012217495306900_jeaa318-B2","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1161\/STROKEAHA.111.631648","article-title":"Patent foramen ovale closure and medical treatments for secondary stroke prevention: a systematic review of observational and randomized evidence","volume":"43","author":"Kitsios","year":"2012","journal-title":"Stroke"},{"key":"2021012217495306900_jeaa318-B3","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1056\/NEJMoa1009639","article-title":"Closure or medical therapy for cryptogenic stroke with patent foramen ovale","volume":"366","author":"Furlan","year":"2012","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B4","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1056\/NEJMoa1301440","article-title":"Closure of patent foramen ovale versus medical therapy after cryptogenic stroke","volume":"368","author":"Carroll","year":"2013","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B5","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1212\/WNL.0000000000002961","article-title":"Practice advisory: recurrent stroke with patent foramen ovale (update of practice parameter)","volume":"87","author":"Mess\u00e9","year":"2016","journal-title":"Neurology"},{"key":"2021012217495306900_jeaa318-B6","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1056\/NEJMoa1211716","article-title":"Percutaneous closure of patent foramen ovale in cryptogenic embolism","volume":"368","author":"Meier","year":"2013","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B7","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.jacc.2015.12.023","article-title":"Device closure of patent foramen ovale after stroke: pooled analysis of completed randomized trials","volume":"67","author":"Kent","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2021012217495306900_jeaa318-B8","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1056\/NEJMoa1610057","article-title":"Long-term outcomes of patent foramen ovale closure or medical therapy after stroke","volume":"377","author":"Saver","year":"2017","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B9","doi-asserted-by":"crossref","first-page":"335","DOI":"10.7326\/M17-2679","article-title":"Device closure versus medical therapy alone for patent foramen ovale in patients with cryptogenic stroke: a systematic review and meta-analysis","volume":"168","author":"Shah","year":"2018","journal-title":"Ann Intern Med"},{"key":"2021012217495306900_jeaa318-B10","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1056\/NEJMoa1705915","article-title":"Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke","volume":"377","author":"Mas","year":"2017","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B11","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1056\/NEJMoa1707404","article-title":"Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke","volume":"377","author":"S\u00f8ndergaard","year":"2017","journal-title":"N Engl J Med"},{"key":"2021012217495306900_jeaa318-B12","doi-asserted-by":"crossref","first-page":"3182","DOI":"10.1093\/eurheartj\/ehy649","article-title":"European position paper on the management of patients with patent foramen ovale. 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