{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T12:04:25Z","timestamp":1753358665359,"version":"3.37.3"},"reference-count":52,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,10]],"date-time":"2018-10-10T00:00:00Z","timestamp":1539129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>A patent foramen ovale (<jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content>) is implicated in several pathologic processes, including that of cryptogenic stroke (<jats:styled-content style=\"fixed-case\">cCVA<\/jats:styled-content>). Recent trials identify \u201chigh\u2010risk\u201d <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content>s in patients with <jats:styled-content style=\"fixed-case\">cCVA<\/jats:styled-content> as likely to benefit from percutaneous closure. The younger the patient (&lt;60\u00a0years old) the more likely a <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> may be attributable to the <jats:styled-content style=\"fixed-case\">cCVA<\/jats:styled-content>. The Ro<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> Score index helps determine the likelihood that an existing <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> is related to a <jats:styled-content style=\"fixed-case\">cCVA<\/jats:styled-content>. This may help guide the clinician and patient when contemplating percutaneous <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> closure. When evaluating a patient for possible percutaneous closure, one should identify the <jats:styled-content style=\"fixed-case\">CVA<\/jats:styled-content> as a typical ischemic type stroke. In order to \u201crule\u2010out\u201d other causes of <jats:styled-content style=\"fixed-case\">CVA<\/jats:styled-content>, imaging of the intracranial arteries, cervical, and aortic arch vessels should be performed. Small vessel disease or a lacunar\u2010type infarct should be excluded. To rule out atrial fibrillation, prolonged monitoring should be performed. An index has been developed to determine the probability that a <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> is the causative etiology and calculates the risk of recurrence. This may help guide the clinician and patient in the decision for <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> closure. In addition, one should consider a work\u2010up for a hypercoagulable state. We will obtain an ultrasound of the lower extremities or consider deep pelvic vein thrombosis (prolonged sitting or malignancy). If the closure is to be performed, the Food and Drug Administration (<jats:styled-content style=\"fixed-case\">FDA<\/jats:styled-content>) has approved the Amplatzer <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content> Occluder and the <jats:styled-content style=\"fixed-case\">GORE<\/jats:styled-content> Cardioform Septal Occluder for percutaneous closure. These devices are both approved in patients predominately between ages 18 and 60\u00a0years with a <jats:styled-content style=\"fixed-case\">cCVA<\/jats:styled-content> due to presumed paradoxical embolism as verified by a neurologist and cardiologist and when other causes of ischemic <jats:styled-content style=\"fixed-case\">CVA<\/jats:styled-content> have been excluded. \u201cHigh\u2010risk\u201d <jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content>s appear to achieve the most potential benefit from percutaneous closure.<\/jats:p>","DOI":"10.1111\/echo.14154","type":"journal-article","created":{"date-parts":[[2018,10,10]],"date-time":"2018-10-10T10:19:01Z","timestamp":1539166741000},"page":"1860-1867","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Identification of candidates for <scp>PFO<\/scp> closure in the echocardiography 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