{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:54:04Z","timestamp":1791309244213,"version":"4.3.1"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The decision to close patent foramen ovale (PFO) depends on the size of PFO, the coexistence of interatrial septum aneurysm, and the importance of right\u2010to\u2010left shunt assessed by the number of bubbles on transcranial Doppler (TCD) and echocardiography after saline or glucose injection. The interventional threshold for the number of bubbles is considered to be the same for trans\u2010thoracic and trans\u2010esophageal echocardiography (TTE and TEE) and TCD. Our objective was to study whether the same thresholds can be used for TCD and echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In this comparative, observational study, we modeled a linear relationship between the number of bubbles on TCD and echocardiography, which suggests a different threshold between TCD and TTE\/TEE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found a systematic difference between TTE\/TEE and TCD for the number of bubbles in the same patient. From linear regression, we found the following equation: TCD\n                      <jats:sub>Estimate<\/jats:sub>\n                      \u2009=\u2009(7.2 (95% CI: \u22122.36\u201316.8)\u2009+\u2009(2.67 (95% CI: 1.85\u20133.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001))\u2009\u00d7\u2009\n                      <jats:italic>TTE\/TEE<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Different thresholds for the decision to close a PFO should be used for both techniques: 20 bubbles for echocardiography and 60 bubbles for TCD.<\/jats:p>\n                  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