RESEARCH ARTICLE Transcatheter patent foram s

Full list of author information is available at the end of the articlein nature [1-5]. Multiple observational studies have dem-onstrated an association between cryptogenic stroke and patent foramen ovale (PFO) [6-15]. The prevalence of PFO in the general community is around 25 to 30 % of in-dividuals based on autopsy and community based trans-esophageal echocardiography (TEE) studies [16,17]. The prevalence of PFO is about 60 % in patients with crypto-genic strokes [18], supporting an etiological association. Most patients with cryptogenic stroke are less than 55 years of age with significant cost implications both in the short and long term [17,19-21]. The optimal treat-ment strategy of secondary prevention for patients with cryptogenic stroke is still unclear. To date, there have been several observational studies and three randomized trials evaluating the safety and efficacy of transcatheter closure versus medical therapy in reducing the risk of re-current stroke in this patient population [22-24]. Two recent meta-analyses of observational studies favored transcatheter closure over medical therapy in preventin