What evidence supports device closure for PFOs in younger patients without other vascular risk factors?
Analysis of observations indicates that younger patients without other vascular risk factors are more likely to have PFOs that are related to their stroke. Furthermore, the individual patient level meta-analysis of the first 3 trials found slightly greater benefit among patients with these characteristics, but the differences did not approach statistical significance. In contrast, the RESPECT showed significant interactions between treatment and both larger shunt size (>20 micro-bubbles) and atrial septal aneurysm, with benefit shown only when either was present.