Case–control studies have shown an association between patent foramen ovale (PFO) and cryptogenic stroke, particularly among patients younger than 55 years of age and among patients with an associated atrial septal aneurysm or a substantial right-to-left interatrial shunt. The role of closure of PFO in preventing stroke recurrence in these patients remains uncertain. Although it is plausible that closure of the defect could reduce the risk of recurrent stroke, several randomized trials have not shown the superiority of PFO closure over antithrombotic therapy.