In patients with cryptogenic stroke and patent foramen ovale, options for stroke prevention include medical therapy (antiplatelet therapy or anticoagulation) and percutaneous device closure. In the only completed randomized controlled trial comparing medical therapy and percutaneous device closure, there was no difference in outcome between the two forms of treatment, and both are viable options for stroke prevention. The choice of therapy is made after careful weighing of potential risks and benefits associated with each form of therapy based on the limited evidence to date and the anticipated patient adherence with the planned treatment. Participation in a clinical trial is a third option for these patients.
Address correspondence to Dr Cheryl Jaigobin, Toronto General Hospital, 5 Eaton Centre-Room 306, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada, email@example.com.
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