In Reply Powers raises several important issues that I did not address in detail in my Viewpoint1 about managing patent foramen ovale in patients with ischemic stroke. These additional points further highlight that many patients who are fully informed about the available data will reasonably choose medical therapy rather than patent foramen ovale closure.
Kamel H. Additional Factors in Considering Patent Foramen Ovale Closure to Prevent Recurrent Ischemic Stroke—Reply. JAMA Neurol. 2018;75(7):895–896. doi:10.1001/jamaneurol.2018.1022
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