Economic evaluation of percutaneous patent foramen ovale closure versus medical therapy in patients with a cryptogenic stroke: a systematic review.

INTRODUCTION

A patent foramen ovale (PFO) closure reduces the risk of recurrent cryptogenic ischemic strokes in young to middle-aged patients. We aimed to review the studies on the cost-effectiveness of percutaneous closure of a PFO in comparison to medical therapy in the prevention of cryptogenic strokes in patients with a PFO.

METHODS

This systematic review searched PubMed, EMBASE, Web of Science, Cochrane, and Scopus from 1990 to 2025.

RESULTS

Twelve articles qualified for inclusion. Closed PFOs resulted in a quality-of-life gain of 3.25 to 4.55 years for most countries. According to the study, the incremental cost-effectiveness ratio per year of life gained was between $3,882.54 and $248,590. Percutaneous closure of the PFO has been found to be cost-effective compared to medical therapy in most countries, with the exception of Argentina.

CONCLUSIONS

On the basis of the results of the present study, percutaneous closure of the PFO was cost-effective compared to medical therapy in preventing a cryptogenic stroke in patients with a PFO. A majority of studies were conducted in countries with high incomes. Further studies on the cost-effectiveness of percutaneous closure of the PFO are required in low- and middle-income countries.

REGISTRATION: PROSPERO (CRD42024544835).