August 1, 2021EuroInterventionOpen Access

European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions

Q: What is the clinical evidence from this study?

Study design: Review. Population: Patent foramen ovale (PFO) with decompression sickness, migraine, or arterial deoxygenation syndromes. Intervention: Percutaneous PFO closure vs. Medical therapy or behavioral avoidance.

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Why the study?

PFO is implicated in multiple medical conditions, but official guidance had previously addressed only left circulation thromboembolism.

Design

Interdisciplinary position paper using modified GRADE methodology

Authors

CPChristian PristipinoUniversità Cattolica del Sacro Cuore PGPeter GermonpréHaute École de Bruxelles DTDanilo ToniUniversity of Lethbridge

Discussion

Member takes

Implication

May warrant individualized PFO closure consideration in select cases; extends guidelines while leaving evidence gaps open.

Structured PICO

Population

Patients with patent foramen ovale (PFO) and decompression sickness, migraine, arterial deoxygenation syndromes, or select high-risk clinical conditions

Intervention

PFO management strategies including percutaneous closure and behavioural/technical changes

This interdisciplinary position paper provides evidence-based statements for managing patent foramen ovale in clinical scenarios beyond left circulation thromboembolism, such as decompression sickness and migraine.

Limitations

Low or very low certainty of existing evidence
High heterogeneity of patients
Low number of patients with similar characteristics precludes adequately powered studies
low or very low certainty of existing evidence
limited and observational or low-certainty randomised data
lack of systematic and prospective evaluations of PFO-associated decompression sickness

Cite This Study

Pristipino et al. (2021) conducted a review in Patent foramen ovale (PFO) with decompression sickness, migraine, or arterial deoxygenation syndromes. Percutaneous PFO closure vs. Medical therapy or behavioral avoidance was evaluated. Percutaneous closure of patent foramen ovale may be considered for select patients with decompression sickness, migraine with aura, or arterial deoxygenation syndromes, though evidence certainty remains low.

synapsesocial.com/papers/6a83012528b8a62be998fbf7 https://doi.org/10.4244/eij-d-20-00785

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European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider