A systematic review of closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and cryptogenic stroke or transient ischemic attack

Assessment of Morphology of Patent Foramen Ovale with Transesophageal Echocardiography in Symptomatic and Asymptomatic Patients

“…1 Moreover, the risk of ischemic stroke is still higher after PFO closure compared with the normal population. 9 These findings show that ischemic stroke in patients with PFO might be multifactorial including genetic, hemostatic, and certain features of PFO morphology. Prothrombin gene polymorphism, .001 ASA presence, n (%) 24 (38) 11 (11) .005…”

Long‐term follow‐up after PFO device closure

“…Three recent randomized‐controlled trials comparing medical therapy to device closure of PFO for preventing recurrent stroke have failed to demonstrate a statistically significant benefit . Remarkably, at least 18 subsequent meta‐analyses have evaluated these three studies for the cumulative potential benefit of PFO closure on preventing recurrent neurologic events . Half of these analyses concluded that there was no benefit of PFO closure for secondary prevention of stroke or TIA .…”

“…Remarkably, at least 18 subsequent meta‐analyses have evaluated these three studies for the cumulative potential benefit of PFO closure on preventing recurrent neurologic events . Half of these analyses concluded that there was no benefit of PFO closure for secondary prevention of stroke or TIA . Five others concluded that there was either a benefit or a trend toward benefit of closure over medical therapy .…”

PFO Closure for Cryptogenic Stroke

“…Several meta-analyses emphasize that lack of blinding and selection bias is a primary concern, as well as relatively short follow-up periods and low rates of stroke and TIA in all three trials [51,52]. The low event rates may suggest that medical therapy is more effective than previously found, although there was no direct comparison of anticoagulation versus antiplatelet therapy in the studies.…”