| Paper | |
|---|---|
| (CLOSE) Patent Foramen Ovale Closure or Anticoagulation vs Antiplatelets after Stroke _____ RCT assigning patients aged 16-60 with recent stroke attributed to PFO with an atrial septal aneurysm or large interatrial shunt to PFO closure + antiplatelet, antiplatelet alone, or oral anticoagulation. There were fewer recurrent strokes with PFO closure than with antiplatelets alone, but with some device complications and increased incidence of atrial fibrillation. | LINK |
| (REDUCE) Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke _____ RCT comparing PFO closure + antiplatelets to antiplatelets alone in patient aged 18-59 with recent cryptogenic stroke for recurrent clinical stroke and for new infarcts on imaging at 24 months, finding significantly fewer recurrent clinical strokes with PFO closure as well as MRI infarcts, though no difference in silent infarct incidence. PFO closure was associated with some device complications and significantly higher incidence of atrial fibrillation. | LINK |
| (RESPECT) Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke _____ RCT comparing medical therapy to PFO closure in patients 18-60 with cryptogenic stroke for recurrent stroke or early death, finding a lower rate of recurrent stroke (particularly of undetermined cause) in the PFO closure group, though with a higher incidence of VTE events. | LINK |
| Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke _____ Data pooled from the randomized trials evaluating PFO closure vs medical therapy were used for subgroup analysis according to ROPE and PASCAL scores to assess treatment effect by score stratification, demonstrating a higher likelihood of benefit from PFO closure in scoring groups that were more suggestive of PFO-related stroke. | LINK |