نبذة مختصرة : Background The RoPE score calculator has been suggested to stratify patients in whom the patent foramen ovale (PFO) should be considered a causative factor for stroke. Methods We reviewed the medical and instrumental data of 1040 consecutive patients (mean age 47.3±17.1 years, females) prospectively enrolled in two centres over a 13 year period for management of PFO in order to select anatomic and functional parameters to be incorporated in a modified RoPE score. A scoring system (AF-RoPE) was build up and applied in a prospective blinded fashion to a cohort of 406 consecutive patients (mean age 43.6 ±17. 5 years, 264 females) with cryptogenic stroke and PFO, comparing its performance with the standard RoPE. Results Multiple stepwise logistic regression analysis demonstrated that right-to-left (R-L) shunt at rest (OR 5.9), huge ASA (> 20 mm) (OR 3.9), long tunnelized PFO (> 12 mm) (OR 3.5), and massive R-L shunt (grade 5 by TCD) (OR 1.9) conferred the highest risk of recurrent stroke. The AF-RoPE score resulted in a more precise separation of patients with RoPE score 8-10. Patients with AF-RoPE score > 11 had more stroke recurrences and more diffuse area of stroke on MRI in the medical history than those ranging from 10 to 7 or less (85.2 and 68.5 % respectively, p
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