What is the effect of device closure versus medical therapy alone for patent foramen ovale in patients with cryptogenic stroke?
A systematic review and meta-analysis published in the Annals of Internal Medicine in 2018 showed that device closure was more effective than medical therapy alone for patent foramen ovale in patients with cryptogenic stroke. The meta-analysis included six randomized controlled trials with a total of 1,072 patients. The results showed that device closure was associated with a significant decrease in risk of recurrent stroke compared to medical therapy alone (RR 0.48; 95% CI 0.31, 0.75). Additionally, device closure was also associated with a significant reduction in risk of combined stroke, myocardial infarction, and death compared to medical therapy alone (RR 0.73; 95% CI 0.56, 0.95). This systematic review and meta-analysis suggests that device closure may be a more effective treatment option for patent foramen ovale in patients with cryptogenic stroke than medical therapy alone.  