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Patent Foramen OvaleSTOPNCT05907694

Medical Treatment With or Without Transcatheter Patent Foramen Ovale Closure

A study testing Transcatheter PFO closure and Optimal medical treatment in people with Patent Foramen Ovale and Cryptogenic Stroke, run by Josep Rodes-Cabau at 2 sites in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Patent foramen ovale PFO closure has been shown to reduce the risk of stroke in patients with recurrent stroke. However, the majority of existing clinical studies in this field excluded patients over the age of 60 years. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Transcatheter PFO closure and Optimal medical treatment
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
714 participants
Where
2 sitesCanada
Study dates
18 Jun 2024to 1 Oct 2037
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Cryptogenic stroke
  • Age >60 years
  • Right-to-left shunt as evaluated by echocardiography (TEE).

Who cannot join

  • -≤60 year-old
  • Lacunar (small vessel) stroke.
  • Permanent or paroxysmal atrial fibrillation/flutter (clinically apparent or detected by continuous ECG monitoring).
  • Need for chronic anticoagulation therapy.
  • Any contraindication for antiplatelet therapy (aspirin, clopidogrel, ticagrelor).
  • Presence of extracranial or intracranial atherosclerosis causing ≥50% luminal --stenosis in arteries supplying the area of ischemia.
Show all 30Show fewer
  • Presence of complex atheroma plaques at the ascending aorta-aortic arch (≥4-mm-thick, ulcerated or containing mobile thrombi) as evaluated by TEE.
  • Presence of intracardiac thrombus as evaluated by TEE.
  • Uncontrolled hypertension (systemic pressure values >160/90 mmHg despite optimal medical treatment).
  • History of myocardial infarction or coronary intervention. (percutaneous coronary intervention, coronary artery bypass graft).
  • History of prior valve surgery or transcatheter valve repair.
  • Presence of deep venous thrombosis at the time of index stroke as evaluated by Doppler ultrasonography.
  • Left ventricular ejection fraction <50% as evaluated by TTE.
  • Significant (moderate or severe) valvular disease as evaluated by echocardiography.
  • History of congestive heart failure.
  • Severe chronic kidney dysfunction defined an estimated glomerular filtration rate <30 ml/min/m2 or need for dialysis.
  • Isolated ASD or ASD associated with PFO but with a hemodynamically significant left-to-right shunt requiring closure.
  • Other specific cause of stroke identified (eg, arteritis, dissection, migraine/vasospasm, and drug abuse).
  • Prior surgical or endovascular treatments of PFO or ASD.
  • Rheumatic heart disease.
  • Left atrial enlargement defined as a left atrial diameter >41 mm in men and ≥39 mm in women.
  • Presence of high burden of premature atrial contractions (>500 per 24 hrs) as evaluated by continuous ECG monitoring.
  • Follow-up impossible or expected poor compliance.
  • Active cancer.
  • Presence of an inferior vena cava filter.
  • Severe pulmonary artery hypertension (systolic pulmonary pressure >60 mmHg).
  • Functional dependency as measured by a modified Rankin Scale score >3 (unable to attend to own bodily needs without assistance and unable to walk unassisted).
  • Any medical condition determining a life expectancy <2 years.
  • Participation in another randomized study.
  • Failure to provide signed informed consent.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Canada2 sites, 1 recruiting
  • IUCPQ-UL

    Québec, Quebec, G1V 4G5

    Active, not recruiting
  • IUCPQ

    Québec, Quebec, G2E4G9

    Mélanie Côté, 4186537270, melanie.cote@criucpq.ulaval.ca

    Recruiting

Other trials in Canada

About this study

Official title: Medical Treatment With or Without Transcatheter Patent Foramen Ovale CloSure for Older Patients With CrypTogenic StrOke and Patent Foramen Ovale. The STOP Trial

Patent foramen ovale PFO closure has been shown to reduce the risk of stroke in patients with recurrent stroke. However, the majority of existing clinical studies in this field excluded patients over the age of 60 years. Data in older patients is limited and since the population ages and stroke remains a major cause of death and morbidity, randomized clinical trials are needed to better assess the benefit of PFO closure in this elderly population. Therefore, this study proposal sought to determine the efficacy of PFO closure for the prevention of recurrent stroke in older patients with PFO and cryptogenic stroke.

Read the detailed description

Background and importance Consistent with studies performed in younger patient cohorts, older patients suffering a cryptogenic stroke exhibit a much higher prevalence of patent foramen ovale (PFO) compared to their stroke of known origin counterparts. Several studies have provided promising preliminary data regarding PFO closure in older patients with cryptogenic stroke, with very low stroke recurrence rates at mid- to long-term follow-up. Several randomized trials have shown the beneficial effects of PFO closure vs. medical treatment in patients younger than 60 years with cryptogenic stroke and PFO. Current observational data suggest similar or even more marked effects on stroke recurrence prevention of PFO closure in older patients and would support the design of a randomized trial to provide definite evidence in this field. Therefore, the objective of the present study is to evaluate the efficacy of transcatheter PFO closure for preventing recurrent ischemic stroke (nonlacunar) events in patients >60 years diagnosed with a cryptogenic stroke and PFO.

Being tested
Transcatheter PFO closure, Optimal medical treatment
Medical subject headings
Foramen Ovale, Patent, Ischemic Stroke, Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transcatheter PFO closureProcedure or surgery

    Transcatheter PFO closure procedure will be performed according to the standards and experience of each participating center. Any approved PFO occluder device will be allowed in the study.

    Patients will also receive antithrombotic agents (single antiplatelet treatment ), and modifiable vascular risk factors (dyslipidemia, hypertension, diabetes) according to stroke prevention guidelines. The type of antithrombotic therapy will be left to the discretion of the physician responsible for the patient.

  • Optimal medical treatmentDrug

    Patients will receive antithrombotic agents (single antiplatelet treatment ), and modifiable vascular risk factors (dyslipidemia, hypertension, diabetes) according to stroke prevention guidelines. The type of antithrombotic therapy will be left to the discretion of the physician responsible for the patient.

Study groups in NCT05907694
Study groupRoleWhat they receive
transcatheter PFO closure + optimal medical treatmentExperimentalPatients will undergoes transcatheter PFO closure (+ optimal medical treatment). Patients will receive antithrombotic agents (single antiplatelet treatment ), and modifiable vascular risk factors (dyslipidemia, hypertension, diabetes) according to stroke prevention guidelines. The type of antithrombotic therapy will be left to the discretion of the physician responsible for the patient.
Receives: Procedure: Transcatheter PFO closure; Drug: Optimal medical treatment
Optimal medical treatmentExperimentalPatients will receive antithrombotic agents (single antiplatelet treatment ), and modifiable vascular risk factors (dyslipidemia, hypertension, diabetes) according to stroke prevention guidelines. The type of antithrombotic therapy will be left to the discretion of the physician responsible for the patient.
Receives: Drug: Optimal medical treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rate of ischemic events

    New ischemic non-lacunar stroke events

    Measured: 12 months

Secondary outcomes (8)
  1. Rate of stroke events

    All new non-lacunar stroke events

    Measured: 12 months

  2. Rate of mortality

    All cause mortality

    Measured: 10 year follow-up

  3. Rate of cardiovascular mortality

    Cardiovascular death

    Measured: 10 year follow-up

  4. Incidence of cerebral hemorrhage

    Cerebral bleeding

    Measured: 10 year follow-up

  5. Rate of new-onset atrial fibrillation

    All new onset atrial fibrillation episodes

    Measured: 10 year follow-up

  6. Rate of bleeding

    Major/life-threatening bleeding

    Measured: 10 year follow-up

  7. Health-related quality of life

    Evaluated by the EQ-5D-5L questionnaire

    Measured: 10 year follow-up

  8. Neurocognitive assessment

    Evaluated by the MoCA questionnaire

    Measured: 10 year follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jun 2023
  2. Study start18 Jun 2024
  3. Primary completion1 Oct 2027 (estimated)
  4. Study completion1 Oct 2037 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized controlled trial comparing transcatheter PFO closure + medical treatment vs. medical treatment alone.
Masking
None (open label)
Enrolment
714 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05907694
Sponsor's protocol ID
STOP
Acronym
STOP
Status last verified
Mar 2026
First submitted
8 Jun 2023
Last updated
27 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, Kamel H, Kernan WN, Kittner SJ, Leira EC, Lennon O, Meschia JF, Nguyen TN, Pollak PM, Santangeli P, Sharrief AZ, Smith SC Jr, Turan TN, Williams LS. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2021 Jul;52(7):e364-e467. doi: 10.1161/STR.0000000000000375. Epub 2021 May 24. No abstract available.

    PubMed 34024117
  • GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459-480. doi: 10.1016/S1474-4422(18)30499-X. Epub 2019 Mar 14.

    PubMed 30879893
  • Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022 Feb 22;145(8):e153-e639. doi: 10.1161/CIR.0000000000001052. Epub 2022 Jan 26.

    PubMed 35078371
  • Zhao W, Wu J, Liu J, Wu Y, Ni J, Gu H, Tu J, Wang J, An Z, Ning X. Trends in the incidence of recurrent stroke at 5 years after the first-ever stroke in rural China: a population-based stroke surveillance from 1992 to 2017. Aging (Albany NY). 2019 Mar 19;11(6):1686-1694. doi: 10.18632/aging.101862.

    PubMed 30888967
  • Cho KK, Khanna S, Lo P, Cheng D, Roy D. Persistent pathology of the patent foramen ovale: a review of the literature. Med J Aust. 2021 Jul;215(2):89-93. doi: 10.5694/mja2.51141. Epub 2021 Jul 4.

    PubMed 34218432
  • Molnar AA, Abraham P, Merkely B, Nardai S. Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure. J Vis Exp. 2022 Feb 8;(180). doi: 10.3791/61240.

    PubMed 35225286
  • Ho SY, McCarthy KP, Rigby ML. Morphological features pertinent to interventional closure of patent oval foramen. J Interv Cardiol. 2003 Feb;16(1):33-8. doi: 10.1046/j.1540-8183.2003.08000.x.

    PubMed 12664815
  • Agarwal S, Bajaj NS, Kumbhani DJ, Tuzcu EM, Kapadia SR. Meta-analysis of transcatheter closure versus medical therapy for patent foramen ovale in prevention of recurrent neurological events after presumed paradoxical embolism. JACC Cardiovasc Interv. 2012 Jul;5(7):777-89. doi: 10.1016/j.jcin.2012.02.021.

    PubMed 22814784
  • Alsheikh-Ali AA, Thaler DE, Kent DM. Patent foramen ovale in cryptogenic stroke: incidental or pathogenic? Stroke. 2009 Jul;40(7):2349-55. doi: 10.1161/STROKEAHA.109.547828. Epub 2009 May 14.

    PubMed 19443800
  • Lechat P, Mas JL, Lascault G, Loron P, Theard M, Klimczac M, Drobinski G, Thomas D, Grosgogeat Y. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med. 1988 May 5;318(18):1148-52. doi: 10.1056/NEJM198805053181802.

    PubMed 3362165
  • Handke M, Harloff A, Olschewski M, Hetzel A, Geibel A. Patent foramen ovale and cryptogenic stroke in older patients. N Engl J Med. 2007 Nov 29;357(22):2262-8. doi: 10.1056/NEJMoa071422.

    PubMed 18046029
  • Pristipino C, Sievert H, D'Ascenzo F, Louis Mas J, Meier B, Scacciatella P, Hildick-Smith D, Gaita F, Toni D, Kyrle P, Thomson J, Derumeaux G, Onorato E, Sibbing D, Germonpre P, Berti S, Chessa M, Bedogni F, Dudek D, Hornung M, Zamorano J; Evidence Synthesis Team; Eapci Scientific Documents and Initiatives Committee; International Experts. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J. 2019 Oct 7;40(38):3182-3195. doi: 10.1093/eurheartj/ehy649.

    PubMed 30358849
  • Chen JZ, Thijs VN. Atrial Fibrillation Following Patent Foramen Ovale Closure: Systematic Review and Meta-Analysis of Observational Studies and Clinical Trials. Stroke. 2021 May;52(5):1653-1661. doi: 10.1161/STROKEAHA.120.030293. Epub 2021 Feb 22.

    PubMed 33611943
  • Hakeem A, Cilingiroglu M, Katramados A, Boudoulas KD, Iliescu C, Gundogdu B, Marmagkiolis K. Transcatheter closure of patent foramen ovale for secondary prevention of ischemic stroke: Quantitative synthesis of pooled randomized trial data. Catheter Cardiovasc Interv. 2018 Nov 15;92(6):1153-1160. doi: 10.1002/ccd.27487. Epub 2018 Jan 14.

    PubMed 29332308
  • Musto C, Cifarelli A, Dipasquale F, Chin D, Nazzaro MS, Stio RE, Pennacchi M, De Felice F. A Comparison Between Gore Cardioform and Amplatzer Septal Occluder for Percutaneous Closure of Patent Foramen Ovale Associated With Atrial Septal Aneurysm: Clinical and Echocardiographic Outcomes. J Invasive Cardiol. 2021 Nov;33(11):E857-E862. doi: 10.25270/jic/20.00655. Epub 2021 Oct 15.

    PubMed 34653958

Questions about this trial

What is this clinical trial studying?

A study testing Transcatheter PFO closure and Optimal medical treatment in people with Patent Foramen Ovale and Cryptogenic Stroke, run by Josep Rodes-Cabau at 2 sites in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Josep Rodes-Cabau, MD, PhD (4186568711, josep.rodes@criucpq.ulaval.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of ischemic events (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05907694, which also lists 37 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2026.

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