Key result
PFO closure lowers recurrent stroke and major events vs antithrombotic therapy but increases AFib.
Why the study?
Although patent foramen ovale is more common in cryptogenic stroke, the benefit of closure over antithrombotic therapy remains debated.
Does percutaneous patent foramen ovale closure reduce recurrent stroke and composite events in people with cryptogenic stroke compared with anti-thrombotic therapy?
Meta-Analysis
Does percutaneous patent foramen ovale closure reduce recurrent stroke and composite events in people with cryptogenic stroke compared with anti-thrombotic therapy?
p-value: p=<0.001
PFO closure effectively reduces recurrent stroke and composite events in selected patients with cryptogenic stroke compared to antithrombotic therapy, though it carries a higher risk of atrial fibrillation.
Supports PFO closure in selected cryptogenic stroke patients; reinforces updated RCT evidence versus antithrombotic therapy.**[[1]](https://pubmed.ncbi.nlm.nih.
BACKGROUND: Stroke is a leading cause of death and disability. Patent foramen ovale (PFO) is more common in cryptogenic stroke, but the benefit of closure over antithrombotic therapy remains debated. We updated randomized evidence comparing PFO closure with antithrombotic therapy. METHODS: MEDLINE, Embase, and Cochrane Central were searched through September 2025. Primary outcomes were stroke, transient ischemic attack (TIA), and a composite of stroke, TIA, death, or systemic embolism. Serious adverse events and atrial fibrillation were assessed. RESULTS: < 0.001). CONCLUSION: In selected patients, PFO closure lowers recurrent stroke and composite events versus antithrombotic therapy, at the cost of higher atrial fibrillation. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251167260.
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Tewari et al. (2026) conducted a meta-analysis in cryptogenic stroke. percutaneous patent foramen ovale closure vs. antithrombotic therapy was evaluated on stroke, transient ischemic attack (TIA), and a composite of stroke, TIA, death, or systemic embolism (p=<0.001). Percutaneous patent foramen ovale closure lowers recurrent stroke and composite events versus antithrombotic therapy in patients with cryptogenic stroke (P<0.001), but increases atrial fibrillation.
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