Evidence map›Paper›PMID 37221985›Full record

ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2023

Anatomical predictors for suture-based closure of the patent foramen ovale: A multicenter experience.

Lars S Witte, Mick P L Renkens, Aleksandra Gąsecka, Abdelhak El Bouziani, Robbert J de Winter, Jan G P Tijssen, Pieter R Stella, Gregor Leibundgut, Michiel Voskuil

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Treatment of patent foramen ovale.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Lars S WitteDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-0159-0754
Mick P L RenkensDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-1997-1918
Aleksandra GąseckaDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Abdelhak El BouzianiDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Robbert J de WinterDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Jan G P TijssenDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Pieter R StellaDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Gregor LeibundgutDepartment of Cardiology, Cantonal Hospital Baselland, Liestal, Switzerland.ORCID 0000-0002-0122-5397
Michiel VoskuilDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNobleStitch EL is a novel suture-based technique used for patent foramen ovale (PFO) closure and an alternative to traditional double-disc devices without the need for antithrombotic therapy. However, successful closure rates are still unknown, and certain anatomies may be unfavorable for successful closure.

aimsWe assessed the efficacy of the NobleStitch EL and sought to identify patient-related anatomical features associated with successful suture-based closure.

methodsWe included 55 patients who underwent PFO closure with the NobleStitch EL in The Netherlands and Switzerland. Successful closure was defined as residual right-to-left shunt grade ≤1 with Valsalva maneuver at a cardiac ultrasound. Predefined possible anatomical determinants for effective closure included PFO length, atrial septal aneurysm, PFO entry- and exit diameter.

resultsSuccessful closure was achieved in 33 patients (60%). The PFO length was shorter in patients with successful closure compared to unsuccessful closure with a median length of 9.6 mm (IQR 8.0-15.0) versus 13.3 mm (IQR 11.4-18.6) on preprocedural ultrasound (p = 0.041) and 9.9 mm (IQR 8.0-13.1) versus 12.5 mm (IQR 9.7-15.4) on angiography (p = 0.049). Additionally, the PFO exit diameter and PFO volume were smaller in patients with successful closure than unsuccessful closure, with a mean diameter of 7.0 ± 3.1 mm versus 9.5 ± 3.8 mm (p = 0.015) and a median volume of 381 mm

conclusionIn our study cohort, the successful PFO closure rate using NobleStitch EL was relatively low (60%). With this alternative procedure, patients with a small PFO driven by a short PFO tunnel length and small exit diameter seem to be eligible for successful suture-based closure.

Indexed as

Foramen Ovale, PatentStrokeCardiac CatheterizationEchocardiography, TransesophagealHumansSuturesTreatment Outcomecryptogenic strokeheartstitchNobleStitch EL procedurepatent foramen ovalePFO closure

Identifiers

PMID37221985

What OpenQuestion holds

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Registered trials

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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.