ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025
Prevalence, classification, and treatment of residual shunt after patent foramen ovale closure.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07724171 (Long-term Clinical Outcomes and Prognostic Factors After Percutaneous Patent Foramen Ovale Closure), which is not on this map. Cited by 3 papers.
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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.
Long-term Clinical Outcomes and Prognostic Factors After Percutaneous Patent Foramen Ovale Closure: A Retrospective Cohort Study With Prospective Registry Extension
Who cites it
3 citing papers in PubMed.
- Diagnosis and Management of Patients with Patent Foramen Ovale: Current Evidence and Future Perspective.Journal of cardiovascular development and disease · 2026Review
- Beyond Device Sizing: Dynamic Tissue Interaction in Patent Foramen Ovale Closure.JACC. Case reports · 2026Article
- Does a positive bubble study after PFO closure matter: is it much ado about nothing or an indication for reintervention?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResidual shunt (RS) after transcatheter patent foramen ovale (PFO) closure has been associated with an increased risk of recurrent stroke over long-term follow-up. However, RS prevalence, anatomical characteristics, and treatment strategies are poorly understood.
aimsThis study aimed to assess the prevalence and causes of RS, as well as to evaluate the safety and feasibility of its percutaneous treatment.
methodsPatients with RS at transcranial Doppler after transcatheter PFO closure in three Italian high-volume centres between 2000 and 2022 were included. The prevalence and anatomical characteristics of RS, its relationship with the original occluding device, and the procedural details of percutaneous treatment were assessed.
resultsAmong the 2,362 patients who underwent PFO closure, any grade and significant RS were diagnosed in 8.8% and 3.6% of patients, respectively. It was more frequently found after use of the NobleStitch system than after double-disc device implantation (20.0% vs 8.5%; p<0.00001). Among double-disc device implantations, a higher rate of shunt was found with stiffer devices (9.8% vs 7.1%; p<0.05) and with devices larger than 25 mm (13.9% vs 6.6%; p<0.00001). Intradiscal RS (type 1) was most common (43.6%), followed by extradiscal RS (type 2; 35.1%) and RS due to unusual causes (type 3; 14.9%). Percutaneous treatment was successful in 89.4% of patients using different, anatomically tailored devices.
conclusionsRS is commonly found after transcatheter PFO closure and is significantly associated with the type and size of the occluding device implanted. It results from different mechanisms and can be safely and effectively treated by a percutaneous, patient-tailored approach in a high percentage of cases.
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