Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Updated AAN advisory outlines when PFO closure may be option for patients with stroke

Key clinical point: Patients with an embolic-appearing infarct who are younger than 60 years, have undergone a thorough evaluation to rule out other stroke mechanisms, and have discussed with doctors the potential risks and benefits of patent foramen ovale (PFO) closure may be candidates for the procedure, according to a practice advisory from the American Academy of Neurology.

Major finding: For patients with cryptogenic stroke and PFO, percutaneous PFO closure probably reduces the risk of stroke recurrence with an absolute risk reduction of 3.4% at 5 years and is associated with a periprocedural complication rate of 3.9%, a meta-analysis suggests.

Study details: A systematic review and meta-analysis of randomized studies published through August 2019.

Disclosures: The practice advisory was developed with financial support from the AAN. A majority of the authors had no relevant conflicts of interest. Several authors disclosed ties to medical device and pharmaceutical companies.


Messé SR et al. Neurology. 2020 Apr 29. doi: 10.1212/WNL.0000000000009443.