The 2022 SCAI Guidelines for the Management of Patent Foramen Ovale were presented at the SCAI Scientific Sessions on May 19, 2022 in Atlanta and simultaneously published in JSCAI.

Present in around 25% of adults, patent foramen ovale (PFO) may result in paradoxical embolism, the risk of which is reduced by percutaneous PFO closure.  A rigorous systematic review was conducted to inform the guidelines.   

The guidelines panel included clinicians, outcomes researchers, guideline methodologists, and PFO patients. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to formulate recommendations and characterize their strength and the strength of the supporting evidence.  

Key recommendations address the utilization of PFO closure for patients with stroke, concomitant atrial fibrillation, lifelong anticoagulation for other indications, migraine, decompression illness, and platypnea-orthodeoxia syndrome.  

All editors: Andrew M. Goldsweig, MD, MSc, RPVI, FSCAI

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