SCAI Guidelines for the Management of Patent Foramen Ovale

BackgroundPatent foramen ovale (PFO) is a vestigial congenital cardiovascular structure present in around 25% of adults. In most cases, PFO entirely benign and requires no treatment. However, it may cause serious complications under certain circumstances.ObjectiveThese evidence-based guidelines from the Society for Cardiovascular Angiography Interventions (SCAI) aim to support patients, clinicians, other stakeholders decisions about management PFO.MethodsSCAI convened multidisciplinary guideline panel balanced minimize potential bias conflicts interest. The Evidence Foundation, registered 501(c)(3) nonprofit organization, provided methodological guideline-development process. Following Grading Recommendations Assessment, Development Evaluation (GRADE) approach, formulated prioritized clinical questions population, intervention, comparison, outcome (PICO) format. A separate technical review team experts conducted systematic reviews evidence, synthesized data, graded certainty evidence across outcomes. then reconvened formulate recommendations supporting remarks informed by results additional contextual factors described GRADE evidence-to-decision framework.ResultsThe agreed on 13 address variations 5 scenarios.ConclusionsKey patient selection closure prevention recurrent PFO-associated stroke, including populations not commonly included randomized studies, scenarios where might serve role outcomes such as migraine headaches decompression illness. has also identified future research priorities advance field.