Abstract
Closure of patent foramen ovale (PFO) is effective secondary prevention after ischemic stroke proven by randomised clinical trials. The key is selection of the right patient by excluding usual cerebrovascular risc factors (atherosclerosis, atrial fibrilation,...).
A suitable tool to identify the proper patient is the ROPE score (risc of paradoxial embolization). Closure of PFO is not indicated either in patients with migraine or in most divers with identified PFO.