PFO management: Neurologists vs cardiologists
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Patent foramen ovale (PFO) is associated with stroke, particularly in younger patients without another identifiable etiology. Therapeutic options available include antiplatelet medications, warfarin, surgical closure, or percutaneous closure, yet there have been no adequate head-to-head trials to guide management decisions.1 We conducted a survey of cardiologists and neurologists to determine current management strategies for patients with PFO.
Methods.
In April 2004, a 17-item questionnaire (see the survey on the Neurology Web site at www.neurology.org) was sent to all neurologists and cardiologists participating as local principal investigators in the CLOSURE-I PFO closure trial (NMT medical), a study comparing PFO closure to medical management. The survey addressed practice patterns prior to participation in the trial focusing on PFO diagnosis, high risk characteristics, treatment choices, and alternative indications for PFO closure. Results were analyzed in aggregate and by specialty. Neurologists and cardiologists were compared using t tests or χ2 tests as appropriate.
Results.
A total of 108 neurologists and 129 cardiologists were surveyed. After two mailings, we received a response from 39% (44% of neurologists, 36% of …
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