{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T15:36:40Z","timestamp":1784993800335,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T00:00:00Z","timestamp":1372291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the incidence of symptomatic recurrent embolic events after patent foramen ovale (PFO) closure and potential causes for these events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>It is well\u2010known that cerebral or other embolic events may occur after PFO closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis of consecutive patients who underwent PFO closure for secondary prevention of embolic events at a single institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1,930 patients (mean age of 50 \u00b1 13.3 years) underwent transcatheter PFO closure. Complete closure occurred in 92%. The annual recurrence rate of embolic events before PFO closure was 22.4% (785 events in 3,497 patient\u2010years). During follow\u2010up (mean 39 months), 63 recurrent events were documented: 25 strokes, 36 transient ischemic attacks (TIAs), and 2 peripheral embolic events. The overall annual recurrence rate after the procedure was 1% per year (63 events in 6,211 patient\u2010years). The majority of events occurred in patients without residual shunts (54\/63). There was no significant association between the presence of a residual shunt and recurrent events [hazard ratio (HR) 1.7; 95% confidence interval (CI) 0.8\u20133.6, <jats:italic>P<\/jats:italic> = 0.16]. The most common cause for recurrent events was atherosclerosis. Nine out of 63 events were considered likely or possible paradoxical embolism due to residual shunt [stroke (2), TIA (5), and peripheral embolism (2)]. After PFO closure, the annual rate of events potentially related to paradoxical embolism was 0.14% (9 events in 6,211 patient\u2010years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of symptomatic embolic events after PFO closure is low. Most recurrent events are related to coexistent conditions associated with thromboembolic risk rather than residual shunts. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.24511","type":"journal-article","created":{"date-parts":[[2012,6,18]],"date-time":"2012-06-18T15:29:29Z","timestamp":1340033369000},"page":"541-546","source":"Crossref","is-referenced-by-count":10,"title":["Recurrent events after percutaneous closure of patent foramen ovale"],"prefix":"10.1002","volume":"82","author":[{"given":"Julia","family":"Wallenborn","sequence":"first","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan C.","family":"Bertog","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Franke","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Charleston South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Majunke","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Wilson","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Wunderlich","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Sievert","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/s-0037-1612658","article-title":"Stroke in young adults: The role of paradoxical embolism","volume":"85","author":"Chant H","year":"2001","journal-title":"Thromb Haemost"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805053181802"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-6-461"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)92944-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(95)90212-0"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.524371"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000017498.88393.44"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.10.2407"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1301"},{"key":"e_1_2_6_11_1","first-page":"57","article-title":"Prevention of recurrent cerebral ischemic events in patients with patent foramen ovale and cryptogenic strokes or transient ischemic attacks","volume":"15","author":"Cujec B","year":"1999","journal-title":"Can J Cardiol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.3.347"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.118505"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.8.893"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2003.10.021"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.043"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.10.030"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.2006.00154.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.12.040"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.113.10.e409"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.12.2376"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.suppl_2.II-171"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.593376"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.24511","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.24511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T08:20:20Z","timestamp":1696580420000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.24511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,27]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1002\/ccd.24511"],"URL":"https:\/\/doi.org\/10.1002\/ccd.24511","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,27]]}}}