Recurrent strokes under anticoagulation therapy: Sticky platelet syndrome combined with a patent foramen ovale

Abstract

The sticky platelet syndrome (SPS) is a congenital disorder characterized by platelet hyperaggregability to 
epinephrine and/or adenosine diphosphate; this predisposes affected individuals to acute myocardial infarction, 
ischemic optic neuropathy, recurrent venous thromboembolism, and transient ischemic cerebral attacks and 
strokes. Here, we describe an unusual case with recurrent cerebrovascular accidents due to SPS, in the presence 
of a patent foramen ovale (PFO). We report an unusual case of a 56-year-old female patient with a PFO, who 
suffered from recurrent strokes despite long-term medication with clopidogrel for SPS. The patient underwent 
successful transcatheter closure of the PFO, and, in addition, she has been placed on low-dose acetylsalicylic 
acid. After 18-month follow-up, she demonstrated an intact atrial septum without any vegetations on the 
percutaneous device until today. She has had no further thromboembolic events.