El cierre del Foramen Oval Permeable en pacientes con ictus isquémico de origen criptogénico: un camino de resultados negativos y positivos

  • Antonio Cruz Culebras Unidad de Ictus. Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid
  • Rocio Vera Unidad de Ictus. Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid
Palabras clave: ictus criptogénico, foramen oval permeable, prevención del ictus isquémico, ensayos clínicos, dispositivo de cierre septal

Resumen

Aproximadamente un 40% de los pacientes con ictus criptogénico presentan una comunicación auricular cardíaca, el Foramen Oval Permeable, que está presente en 20-25% de población sana. La  controversia y duda de si conviene cerrar esta estructura cuando se sospecha la embolia paradójica, se ha  planteado para reducir el riesgo de recurrencia. Algunas publicaciones (ensayos clínicos CLOSURE I,  RESPECT 2013 o PC TRIAL) lo desaconsejaban inicialmente, basados en los resultados obtenidos. Nueva  evidencia publicada a finales de 2017 (ensayos CLOSE, REDUCE y RESPECT 2017) cambian el camino de la evidencia para reabrir el debate y acotar a qué pacientes habría que considerar el procedimiento puesto que hay datos suficientes para poder reducir el riesgo de recurrencia en algunos pacientes  seleccionados.

 

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Publicado
2018-06-09