Endovascular patent foramen ovale (PFO) closure was associated with a reduced risk of recurrent stroke in patients with a prior cryptogenic cerebral infarct, according to a recent meta-analysis. A systematic literature search was undertaken that included published pooled data from 5 large randomized clinical trials, which were combined and then subsequently analyzed. Enrolled patients with cryptogenic stroke were assigned to receive standard medical care or to undergo endovascular PFO closure, with a primary outcome of reduction in stroke recurrence rate. Secondary outcomes included rates of transient ischemic attack (TIA), composite outcome of stroke, TIA, and death from all causes, and rates of atrial fibrillation events. Researchers analyzed data for 3,412 patients and found:
- Transcatheter PFO closure resulted in a statistically significant reduced rate of recurrent stroke, compared with medication alone.
- Patients undergoing closure were 58% less likely to have another stroke.
- The number needed to treat with PFO closure to reduce recurrent stroke for 1 patient was 40.
Garg L, Haleem A, Varade S, et al. Patent foramen ovale closure in the setting of cryptogenic stroke: A meta-analysis of five randomized trials. [Published online ahead of print May 24, 2018]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2018.05.005.