Clinical Trial: The Effect of Device Closure of Patent Foramen Ovale in Elderly Patients With Crytogenic Stoke/TCI

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: The Effect of Device Closure of Patent Foramen Ovale in Elderly Patients With Crytogenic Stoke/TCI

Brief Summary: The primary objective is to evaluate if patent foramen ovale (PFO) closure and antiplatelet medical management can reduce the risk of recurrent stroke or transient ischemic attack (TIA) when compared to antiplatelet medical management alone in elderly patients above 50 years of age with a PFO and a history of cryptogenic stroke or TIA.

Detailed Summary:

Prior to birth the fetal heart has a connection between the two atrias of the heart. After labour this connection often closes. About 10-15 % these connections remains open. This phenomenon is called patent foramen ovale or PFO, and is in most cases unsymptomatic.

The prevalence of PFO in patients with crytogenic (without known causes) stroke is much higher (about 40%)than the general population (about 10%). This has led to the theory that the presence of PFO can lead to stroke, by the passage of emboli from the peripheral venous circulation through the PFO to the brain by right-to-left shunting of the blood.

There are no existing data from prospective randomized studies focusing on the effect of device closure PFO in patients with cryptogenic stroke. Some observational retrospective studies have shown a beneficial effect in the reduction of recurrent stoke in patients younger that 50 years with cryptogenic stroke when PFO has been closed with a percutaneous device closure(PCD). Some studies have reported an 0% to 3.4% annual recurrence rate of stroke or TIA in patients treated with PDC. The recurrence rate of stroke or TIA in patients with crytogenic stroke or TIA in ordinary antithrombotic treatment is about 5-15 %.

The primary objective of this study is to assess whether percutaneous device closure of patent foramen ovale is superior to conventional antithrombotic treatment in preventing stroke recurrence in elderly patients above 50 years of age.


Sponsor: Hillerod Hospital, Denmark

Current Primary Outcome: Combined endpoint defined by the time from intervention to either fatal og non-fatal stroke/TIA [ Time Frame: Endpoints assessed every half year starting 1 year after intervention ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • ct-verified stroke 2 years after intervention [ Time Frame: 2 years after intervention ]
  • Death by other causes than Stroke [ Time Frame: Endpoint assessed every half year starting 1 year after intervention ]
  • Examination of residual cardiac right to left shunt after device closure of PFO [ Time Frame: 1 month after intervention ]
  • Complications to device closure of PFO [ Time Frame: few days after intervention ]


Original Secondary Outcome: Same as current

Information By: Hillerod Hospital, Denmark

Dates:
Date Received: November 20, 2009
Date Started: October 2009
Date Completion: June 2015
Last Updated: May 5, 2010
Last Verified: November 2009