O desafio da PFO

https://www.mdcalc.com/calc/3902/risk-paradoxical-embolism-rope-score#:~:text=Identifies%20stroke%2Drelated%20PFO%20in%20patients%20with%20cryptogenic%20stroke.&text=Use%20in%20patients%20with%20cryptogenic,other%20compelling%20cause%20for%20stroke.&text=Patients%20with%20cryptogenic%20embolic%20ischemic%20strokes%20found%20to%20have%20PFO.

Percutaneous PFO closure versus antiplatelet therapy in adults with a prior PFO-associated stroke

• 2.1.In patients between the ages of 18 and 60 with a prior PFO-associated stroke, the SCAI guideline panel recommends PFO closure rather than antiplatelet therapy alone (strong recommendation, moderate certainty of evidence).
  • Remark: This recommendation is independent of patient anatomy (ie, presence of ASA, size of shunt) due to limited clinical data on these sub-populations. A RoPE (risk of paradoxical embolism) score ≥7 may identify patients who are likely to receive greater benefit from PFO closure.