New evidence emerged recently regarding the percutaneous closure of patent foramen ovale (PFO) to prevent recurrent stroke in patients with cryptogenic stroke.

To compare risks for recurrent cerebrovascular events in adults with PFO and cryptogenic stroke who underwent PFO closure versus those who received medical therapy alone.

PubMed, Scopus, and Google Scholar from 1 December 2004 through 14 September 2017; references of eligible studies; relevant scientific session abstracts; and cardiology Web sites.

Randomized controlled trials, published in English, that compared PFO closure using a currently available device with medical treatment alone and that reported, at minimum, the rates of stroke or transient ischemic attack (TIA) or of new-onset atrial fibrillation (AF) or atrial flutter (AFL).

2 investigators independently extracted study data and assessed study quality.

4 of 5 trials comparing PFO closure with medical therapy used commercially available devices. These 4 trials, involving 2531 patients, found that PFO closure reduced the risk for the main outcome of stroke or TIA (risk difference [RD], −0.029 [95% CI, −0.050 to −0.007]) and increased the risk for new-onset AF or AFL (RD, 0.033 [CI, 0.012 to 0.054]). The beneficial effect of PFO closure was associated with larger interatrial shunts (P = 0.034).

Trials were not double-blind, and inclusion criteria were heterogeneous.

Compared with medical treatment, PFO closure prevents recurrent stroke and TIA but increases the incidence of AF or AFL in PFO carriers with cryptogenic stroke.

Italian Ministry of Education, University and Research (MIUR). (PROSPERO: CRD42017074686)

最近出现了有关经皮闭合卵圆孔未闭（PFO）的新证据，以预防隐源性卒中患者复发性卒中。

为了比较接受PFO封闭的PFO和隐源性卒中的成年人与仅接受药物治疗的成年人发生反复脑血管事件的风险。

2004年12月1日至2017年9月14日之间的PubMed，Scopus和Google Scholar；符合条件的研究的参考资料；相关的科学会议摘要；和心脏病学网站。

用英语发表的随机对照试验，比较了使用目前可用的装置与单独使用药物进行PFO封闭的情况，并至少报告了中风或短暂性脑缺血发作（TIA）或新发房颤（AF）或心房扑动（AFL）。

2名研究者独立提取研究数据并评估研究质量。

5个试验中有4个比较了PFO封堵与药物治疗使用的市售设备。这4项试验涉及2531名患者，发现PFO封堵可降低中风或TIA主要预后的风险（风险差异[RD]，-0.029 [95％CI，-0.050至-0.007]），并增加新发风险。发作的AF或AFL（RD，0.033 [CI，0.012至0.054]）。PFO封闭的有益作用与较大的房间分流有关（P  = 0.034）。

试验不是双盲的，并且纳入标准是异类的。

与药物治疗相比，PFO封闭可预防复发性卒中和TIA，但会增加患有隐源性卒中的PFO携带者发生AF或AFL的可能性。

意大利教育，大学与研究部（MIUR）。（PROSPERO：CRD42017074686）