Device Closure Versus Medical Therapy Alone for Patent Foramen Ovale in Patients With Cryptogenic Stroke: A Systematic Review and Meta-analysis

This meta-analysis of 4 RCTs reports patent foramen ovale (PFO) closure with transcatheter device decreased the absolute risk for recurrent stroke by 3.2% compared with medical therapy.

This is one of two meta-analyses evaluating surgical closure vs medical therapy.

 

Closure of PFOs was associated with higher rates of new-onset atrial fibrillation (AF) than medical therapy alone in all trials. In a related editorial, the author advises caution that these findings cannot be extrapolated to patients who have not yet had a stroke, even if patients might have a predisposing condition, such as a hypercoagulable state.