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PFO Closure, Oral Anticoagulants or Antiplatelet Therapy After PFO-associated Stroke in Patients Aged 60 to 80 Years

RecruitingPhase 3Ages 60 Years - 80 YearsAllAssistance Publique - Hôpitaux de Paris
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In plain words

What the trial is, and whether it could suit you

To assess whether PFO closure plus antiplatelet therapy is superior to antiplatelet therapy alone and whether oral anticoagulant therapy is superior to antiplatelet therapy to prevent stroke recurrence in patients aged 60 to 80 years with a PFO with large shunt (\> 20 microbubbles) or a PFO associated with an ASA (\> 10 mm), and an otherwise unexplained ischemic stroke.

Sign in to get the eligibility rules as simple questions to take to your doctor.

📋 Eligibility rules (as published)
Inclusion Criteria: * Man or woman aged 60 to 80 years. * Recent (≤ 6 months) ischemic stroke confirmed by cerebral imaging regardless of symptom duration. * Absence of a more probable cause of stroke than PFO after a standardized etiological work-up (see addenda). * Presence of a PFO with at least 1 of the 2 following characteristics: * PFO with large shunt (\> 20 microbubbles) appearing in the left atrium during at least one of the 3 cardiac cycles after complete opacification of the right atrium, detected either spontaneously or during provocative manoeuvers, on contrast transthoracic (TTE) or transoesophageal (TOE) echocardiography. The diagnosis of PFO by contrast TEE must be confirmed by contrast TOE showing a right-to-left passage of the contrast material across the PFO. * PFO associated with an ASA on transoesophageal echocardiography: excursion \>10 mm * Affiliation to a French Health Insurance system. Informed consent. Exclusion Criteria: * Life expectancy \< 4 years. * Contraindication to both experimental treatments (PFO closure, oral anticoagulant therapy) or to the reference treatment (antiplatelet therapy) (see paragraph 20.5). * Indication to long-term anticoagulant therapy. * mRS \> 3. * Presence of other medical conditions that would lead to inability to complete the study or interfere with the assessment of outcomes. * Previous surgical or transcatheter treatment of PFO or ASA. Expected impossible follow-up or poor compliance. * PFO associated with an atrial septal defect (ASD) requiring closure (significant shunt with impact on the right cavities, elevation of pulmonary pressures or QP/QS\>2) * Patient unable to understand the informed consent form. Patient under tutorship, curatorship, or legal protection.
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What it tests

  • Transcatheter PFO closure
  • Oral Anticoagulant, Direct-Acting
  • Antiplatelet therapy
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Where

42 sites
CHU Amiens
Amiens, France
Centre Hospitalier de la Côte Basque
Bayonne, France
CHU Jean Minjoz
Besançon, France
CHU Bordeaux - GH Pellegrin
Bordeaux, France
CHRU La Cavale Blanche
Brest, France
HCL-Groupement Hospitalier Lyon Est
Bron, France
CHU Côte de Nacre
Caen, France
CHU Clermont Ferrand
Clermont-Ferrand, France

…and 34 more on ClinicalTrials.gov.

🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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