SCAI Technical Review on Management of Patent Foramen Ovale.

Q4 Business, Management and Accounting International Journal of Business and Globalisation Pub Date : 2022-05-19 eCollection Date: 2022-07-01 DOI:10.1016/j.jscai.2022.100040

Andrew M Goldsweig, Sarosh P Batlivala, Karim Al-Azizi, Vikas Aggarwal, Ifeoluwa Babatunde, Yngve Falck-Ytter, Rebecca L Morgan

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Abstract

Background: Patent foramen ovale (PFO) is a common anatomic variant associated with intermittent right-to-left shunting. Transcatheter PFO closure has been proposed to address multiple clinical conditions including stroke, transient ischemic attack, migraine, and decompression illness.

Methods: A systematic review was conducted using the GRADE approach to address 5 questions formulated by the Society for Cardiovascular Angiography and Interventions (SCAI) Guideline Panel in patient, intervention, comparator, outcome (PICO) format. Medical literature from January 2015 through May 2021 was searched. Extracted data underwent review and risk-of-bias assessment by 2 independent researchers. Pooled effect estimates were calculated. Certainty of evidence was determined for each query.

Results: Our search identified 2701 titles and abstracts, of which 30 met eligibility criteria and informed the technical review. Data were abstracted to address outcomes of PFO closure for patients with and without prior stroke, in comparison to antiplatelet therapy, in comparison to anticoagulation, and with various post-procedure antithrombotic regimens.

Conclusion: In appropriately selected patients with prior stroke, transcatheter PFO closure reduces the risk of recurrent stroke more than antiplatelet therapy alone. Evidence to support PFO closure is weaker regarding older patients, anticoagulation, thrombophilia, transient ischemic attack, migraine, and decompression illness. Data from this technical review will inform the SCAI Guideline for Transcatheter Patent Foramen Ovale Closure.

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SCAI 关于气道闭孔管理的技术审查。

背景：卵圆孔未闭（PFO）是一种常见的解剖变异，与间歇性右向左分流有关。经导管 PFO 关闭术已被提出用于治疗多种临床疾病，包括中风、短暂性脑缺血发作、偏头痛和减压病：采用 GRADE 方法对心血管血管造影和介入学会（SCAI）指南小组提出的 5 个问题进行了系统回顾，这些问题以患者、介入、比较者、结果（PICO）的形式提出。检索了 2015 年 1 月至 2021 年 5 月的医学文献。提取的数据由两名独立研究人员进行审查和偏倚风险评估。计算汇总效果估计值。确定了每项查询的证据确定性：我们的搜索确定了 2701 篇标题和摘要，其中 30 篇符合资格标准，为技术审查提供了信息。摘录的数据涉及PFO闭合术对既往中风和未中风患者的疗效、与抗血小板治疗的比较、与抗凝治疗的比较以及与各种术后抗血栓治疗方案的比较：结论：对于经过适当选择的既往中风患者，经导管 PFO 关闭术比单纯抗血小板治疗更能降低中风复发的风险。在老年患者、抗凝、血栓性疾病、短暂性脑缺血发作、偏头痛和减压疾病方面，支持 PFO 关闭术的证据较弱。本次技术审查的数据将为 SCAI 经导管卵圆孔闭合术指南提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Business and Globalisation Business, Management and Accounting-Business, Management and Accounting (all)

CiteScore

0.70

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0.00%

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期刊介绍： IJBG proposes and fosters discussion on various aspects of business and globalisation, including the physical environment and poverty. Topics covered include: - Internationalisation of SMEs - Cross-cultural business - Globalisation and poverty - Business ethics in the global environment - Emerging economies - Immigrant minorities in business - Indigenous enterprises and the global economy - International tourism - Eco-tourism - Sustainable development - Environmental degradation - The impact of oil and gas - Human mobility in a globalised world - Competition in a global economy - Localisation/glocalisation strategies within contemporary globalisation.