What is the evidence that suggests PFO closure is superior to aspirin?
The evidence suggests that PFO closure in appropriately selected patients is superior to aspirin, but it is not known whether closure is superior to warfarin. A comparison of device closure and anticoagulation was not a prespecified analysis in the CLOSE trial (Patent Foramen Ovale Closure or Anticoagulants Versus Antiplatelet Therapy to Prevent Stroke Recurrence),563 but a post hoc underpowered analysis of recurrent stroke found no events in the device closure group and 3 events in the warfarin group, which was not a sta- tistically significant difference.