There's been a fair bit of research coming forward demonstrating that in the younger patient with a stroke, the actual cause may be having had a hole in their heart, something called a patent foramen ovale or a PFO. With more recent data suggesting there really is a marked benefit or closing that PFO, there is now the advent of ways to do so through catheter-based technologies that are minimally invasive. 

In the clinical trials, a young patient with a stroke is defined as someone between ages of in their teenage years up to around age 60. So the standard thing to do for when a young person has a stroke and has subsequently been found to have a PFO is to put that person on strong blood thinners for the rest of their life. The downside of that approach though is that blood thinners make a person more likely to bleed. And there can be some significant life altering consequences for being on blood thinners for the rest of a person's life. 

It involved essentially nothing more than a needle poke in a blood vessel in the leg which allows us to thread up a thin tube or catheter up to the heart through which we can introduce a patch, permanently closing off that PFO and thereby preventing that person from having another stroke by that same mechanism. It's done on an outpatient basis, meaning the patients come in the morning, get the procedure done, and are able to usually go home that same afternoon. We then end up seeing the patients back in clinic for a couple of months afterwards, making sure that they did well and healed up fine. 

By and large, the patients undergoing this procedure do really well. A patient here gets to see more than just one physician, gets a whole team approach to helping them decide what exactly could have caused their stroke and what among the many different options we have can be done to help them live a better quality of life going forward to prevent another stroke from happening.