PFO closure for the prevention of cerebrovascular events in high-risk individuals: an updated and across-the-board meta-analysis

Abstract Introduction Patent foramen ovale (PFO) closure has emerged as a secondary prevention option in patients with PFO and cerebrovascular events. Despite its seemingly established efficacy, associated long-term outcomes – including safety remain unclear. Purpose To ascertain the extent to which percutaneous is able improve clinical cryptogenic vascular Methods We systematically searched MEDLINE, Embase Cochrane CENTRAL for randomized controlled trials (RCTs) observational studies comparing antithrombotic therapy, what concerns recurrent serious adverse events, well mortality. A composite of stroke transient ischemic attack (TIA) was primary endpoint. Data related RCTs, high-risk features, subjected most represented device antiplatelet therapy control were further investigated separately. Study-specific odds ratios (ORs) pooled using traditional meta-analytic techniques, under random- (DerSimonian-Laird method) or fixed-effects (Mantel-Haenszel model. Results Literature search yielded 2145 references, 26 8 regarding RCTs included. Patients undergoing reached 4304, whereas 4180 treated therapy. significantly lower stroke/TIA recurrence (OR 0.35 [0.24–0.53], I2=58%). Moreover, such reduction met statistical significance both 0.34 [0.21–0.54], I2=29%) TIA 0.53 [0.34–0.82], I2=39%), individually. Subgroup analyses focusing only on featuring confirmed these trends, while effects even more pronounced characteristics those On other hand, not neither all-cause 0.76 [0.46–1.27], I2=0%) nor cardiovascular mortality 0.92 [0.37–2.29], I2=0%). events (SAEs) 1.10 [0.94–1.29], major bleeding episodes 0.75 [0.40–1.38], I2=23%) differed between groups. However, increased procedure- device-related complications 12.94 [5.56–30.13], atrial fibrillation flutter 3.35 [1.78–6.30], I2=30%). Conclusion In history when compared medical management, indeed TIA. seems be impacted by this apparently enhanced effect. While general SAEs are comparable approaches, may bring upon increase flutter. Funding Acknowledgement Type funding sources: None.