Observational studyEuropean heart journal. Cardiovascular Imaging2023
Cardiac computed tomography following Watchman FLX implantation: device-related thrombus or device healing?
Observational study in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 41 citations in OpenAlex.
- Left Atrial Appendage Closure: Between Imaging Precision and Uncertain Clinical Benefit.Journal of clinical medicine · 2026Review
- Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Review
- Peripheral endothelialization progression on fluoropolymer-coated left atrial appendage closure devices: Does device position influence healing?HeartRhythm case reports · 2026Article
- Rapid tissue coverage of the fluoropolymer-coated watchman FLX pro: insights from automated deep-learning CT quantification in a high-bleeding-risk patient.European heart journal. Case reports · 2026Article
- Incidence and Predictors of Hypoattenuated Thickening and Device-Related Thrombus at Three Months Postprocedural CT Assessment Following Left Atrial Appendage Occlusion With Amplatzer Devices-A Single-Center Cohort.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Improving cardiac computed tomography angiography image quality and diagnostic confidence for atrial fibrillation after left atrial appendage closure using a second-generation whole-heart motion correction algorithm.Quantitative imaging in medicine and surgery · 2026Article
- Case report: A unified CTA-fluoroscopy roadmap for single-session pulsed field ablation and left atrial appendage occlusion.Frontiers in cardiovascular medicine · 2026Article
- Imaging-defined residual risk after left atrial appendage occlusion: from device surveillance to antithrombotic and reintervention decision considerations.Frontiers in cardiovascular medicine · 2026Review
- Imaging assessment after percutaneous left atrial appendage closure: from immediate to long-term follow-up.European heart journal. Cardiovascular Imaging · 2025Review
- Clinical effectiveness and safety comparison between direct oral anticoagulants and warfarin for nonvalvular atrial fibrillation patients following percutaneous left atrial appendage closure operation intervention: a prospective observational study.BMC pharmacology & toxicology · 2025Observational
- Direct current cardioversion of atrial fibrillation in patients with left atrial appendage occlusion devices.Frontiers in cardiovascular medicine · 2025Article
- Transfabric Leaks After Percutaneous Left Atrial Appendage Occlusion Procedures with the WATCHMAN FLX Device.CJC open · 2024Article
- The Imaging Spectrum of Device-Related Thrombus After Percutaneous Left Atrial Appendage Occlusion.JACC. Case reports · 2024Article
- Flow Dynamic Factors Correlated With Device-Related Thrombosis After Left Atrial Appendage Occlusion.JACC. Advances · 2024Article
- Long-term cardiac computed tomography follow-up after left atrial appendage occlusion.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Observational
- First-in-human left atrial appendage closure using the WATCHMAN FLX Pro device: a case report.European heart journal. Case reports · 2024Article
- Single antiplatelet therapy following Amplatzer left atrial appendage occlusion.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Observational
- Left Atrial Appendage Occlusion and Post-procedural Antithrombotic Management.Journal of clinical medicine · 2024Review
- Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study.Journal of the American Heart Association · 2024Article
- Perioperative Treatment with Rivaroxaban and Dabigatran on Changes of Coagulation and Platelet Activation Biomarkers following Left Atrial Appendage Closure.Cardiovascular therapeutics · 2024Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
aimsCardiac computed tomography (CT) is increasingly utilized during follow-up after left atrial appendage closure (LAAC). Hypoattenuated thickening (HAT) is a common finding and might represent either benign device healing or device-related thrombosis (DRT). The appearance and characteristics of HAT associated with the Watchman FLX have not been previously described. Therefore, we sought to investigate cardiac CT findings during follow-up after Watchman FLX implantation with a focus on HAT and DRT. METHODS AND
resultsRetrospective single-centre, observational study including all patients with successful Watchman FLX implantation and follow-up cardiac CT between March 2019 and September 2021 (n = 244). Blinded analysis of CT images was performed describing the localization, extent, and morphology of HAT and correlated to imaging and histology findings in a canine model. Relevant clinical and preclinical ethical approvals were obtained.Overall, HAT was present in 156 cases (64%) and could be classified as either subfabric hypoattenuation (n = 59), flat sessile HAT (n = 78), protruding sessile HAT (n = 16), or pedunculated HAT (n = 3). All cases of pedunculated HAT and five cases of protruding sessile HAT were considered as high-grade HAT (n = 7). Subfabric hypoattenuation and flat sessile HAT correlated with device healing and endothelialization in histological analysis of explanted devices.
conclusionSubfabric hypoattenuation and flat sessile HAT are frequent CT findings for Watchman FLX, likely representing benign device healing and endothelialization. Pedunculated HAT and protruding HAT are infrequent CT findings that might represent DRT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.