{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:33:36Z","timestamp":1786977216073,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:00:00Z","timestamp":1610064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In this analysis of the EWOLUTION registry, we evaluated the incidence, relevance and predictors of device\u2010related thrombus in a large multi\u2010center real\u2010world cohort undergoing LAAc with the WATCHMAN device.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      We analyzed the 835 patients who underwent percutaneous LAA closure with the WATCHMAN device in the EWOLUTION registry in whom at least one TEE follow up was performed. Patients were 74\u2009\u00b1\u20099 y\/o and were at high risk for stroke and bleeding (CHA2DS2\u2010VASC\u2010Score 4.3\u00a0\u00b1\u20091.7; HAS\u2010BLED\u2010Score 2.3\u00a0\u00b1\u20091.2). Device\u2010related thrombus was detected in 4.1% (34\/835) after a median of 54\u2009days (IQR 42\u2013111\u2009days) with 91.2% (31\/34) being detected within 3\u00a0months after the procedure or at the time of first TEE. Hereby DRT occurred irrespective of postprocedural anticoagulation. Patients with DRT more frequently had long\u2010standing, non\u2010paroxysmal atrial fibrillation (82.4 vs. 64.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.01), evidence of dense spontaneous echo contrast (26.5 vs. 11.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.03) and larger LAA diameters at the ostium (22.8\u00a0\u00b1\u20093.5 vs. 21.1\u00a0\u00b1\u20093.5\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.01) compared to patients without DRT. Left ventricular ejection fraction, device compression ratio and the incidence of renal dysfunction did not differ between the two groups. In a multivariate analysis, only non\u2010paroxysmal atrial fibrillation identified as an independent predictor of developing DRT. Specific treatment of DRT was initiated in 62% (21\/34) of patients whereas resolution was confirmed in 86% (18\/21) of cases. Overall, no significant differences in annual rates of stroke\/TIA or systemic embolism were observed in patients with or without DRT (DRT 1.7 vs. No\u2010DRT 2.2%\/year,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In real\u2010world patients undergoing LAAc with the WATCHMAN device, DRT is rare. DRT was most frequently detected within the first 3\u00a0months after LAAc regardless of post\u2010procedural regimen and was not associated with an increased risk of stroke or SE. While long\u2010standing atrial fibrillation was the only independent factor associated with DRT, medical treatment of DRT resulted in a resolution of thrombi in most cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.29458","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T15:54:49Z","timestamp":1610553289000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Incidence, predictors and outcomes of device\u2010related thrombus after left atrial appendage closure with the WATCHMAN device\u2014Insights from the EWOLUTION real world registry"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-1056","authenticated-orcid":false,"given":"Alexander","family":"Sedaghat","sequence":"first","affiliation":[{"name":"Med. Klinik und Poliklinik II, Herzzentrum, Universit\u00e4tsklinikum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II, Herzzentrum, Universit\u00e4tsklinikum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Wilko","family":"Schrickel","sequence":"additional","affiliation":[{"name":"Med. Klinik und Poliklinik II, Herzzentrum, Universit\u00e4tsklinikum Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcseyin","family":"Ince","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin \u2013 Kardiologie, Allgemeine Innere Medizin und konservative Intensivmedizin Vivantes Klinikum Berlin im Friedrichshain  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey V.","family":"Protopopov","sequence":"additional","affiliation":[{"name":"Department of Cardiology Regional State Hospital  Krasnoyarsk Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Betts","sequence":"additional","affiliation":[{"name":"Oxford Biomedical Research Centre Oxford University Hospitals  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gori","sequence":"additional","affiliation":[{"name":"Kardiologie I, Zentrum f\u00fcr Kardiologie Universit\u00e4tsmedizin Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Sievert","sequence":"additional","affiliation":[{"name":"CardioVascular Center Frankfurt  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizio","family":"Mazzone","sequence":"additional","affiliation":[{"name":"Aritmologia e Elettrofisiologia Cardiaca Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Grygier","sequence":"additional","affiliation":[{"name":"Department of Cardiology Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Wald","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Kardiologie Dominikus Krankenhaus  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Vireca","sequence":"additional","affiliation":[{"name":"Boston Scientific Corp  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Allocco","sequence":"additional","affiliation":[{"name":"Boston Scientific Corp  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas V.A","family":"Boersma","sequence":"additional","affiliation":[{"name":"Cardiology Department St Antonius Hospital  Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EWOLUTION study 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