Interventional closure vs. medical therapy of patent foramen ovale for secondary prevention of stroke: updated meta-analysis

We aimed to explore whether interventional closure of patent foramen ovale (PFO) results in reduction of composite outcome [stroke/transitory ischemic attack (TIA), death, and thrombolysis in myocardial infarction—TIMI bleeding], stroke and stroke/TIA compared to medical treatment in patients with cryptogenic stroke. Searching the PUBMED and Cochrane library database, we performed meta-analysis from all randomized controlled studies that compared effects of interventional PFO closure with medical treatment on stroke prevention. 3560 patients from six randomized trials were included. Interventional PFO closure reduced composite outcome (RR of 0.47, 0.26–0.85, p = 0.01), stroke (RR of 0.38, 0.18–0.82, p = 0.01) and stroke/TIA (RR of 0.56, 0.43–0.74, p