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Risk of Paradoxical Embolism (RoPE) Score

Identifies stroke-related PFO in patients with cryptogenic stroke.

Use in patients with cryptogenic stroke found to have PFO and no other compelling cause for stroke.

years
About the Creator
Dr. David Thaler
Content Contributors
  • Emiliya Melkoumova, MD

Advice

  • Although the RoPE score was not designed to predict treatment effect, other studies have looked at predictors of recurrence in PFO-related stroke (Thaler 2014), which may help in deciding which patients may be appropriate for PFO closure.  
  • Consult cardiology for patients in whom suspicion for PFO-attributable stroke is high based on the RoPE score.

Management

Consider referral for PFO closure in appropriately-selected patients with higher RoPE scores.

Critical Actions

Do not forget to rule out other, or contributing, causes for stroke (i.e. hypercoagulable state), even in patients with high RoPE scores.

Content Contributors
  • Emiliya Melkoumova, MD