Percutaenous patent foramen ovale closure for prevention of recurrent cerebral embolic stroke

Closed 27 Mar 2019

Opened 25 Feb 2019

Overview

NHS England has launched a 30 day consultation on a policy proposition for percutaenous patent foramen ovale closure for prevention of recurrent cerebral embolic stroke.

In the heart, the foramen ovale is a small natural channel which allows blood to flow between the two upper chambers of the foetal heart (the left and right atria). In the majority of people, this channel closes shortly after birth but in approximately 25% it remains open or ‘patent’ and is referred to as a Patent Foramen Ovale (PFO). In a small minority of people this channel could allow a blood clot which has formed in the veins to pass directly into the left side of the heart. From here a clot could travel along the blood vessels to different parts of the body and may cause a blockage. A stroke may occur if the blockage happens in a vessel in the brain. If the blockage here is only temporary a brief stroke-like episode called a transient ischaemic attack (TIA) is the result. Most people who have had a stroke or TIA because of a PFO take regular medications to reduce the clotting tendency of the blood in order to reduce the chance of another event.   An alternative approach to preventing recurrent strokes is to guide an “occluder” device through the veins into the heart and block up the PFO using a small closure device.

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