{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:46:43Z","timestamp":1785199603250,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T00:00:00Z","timestamp":1518998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study is to compare the long\u2010term outcomes of patent foramen ovale (PFO) closure using angiography or transesophageal echocardiography as procedural guidance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The interventional treatment is emerging as a safe and efficient option for patients with high likelihood of PFO\u2010related cryptogenic stroke and high risk of recurrence. The \u201cgold\u2010standard\u201d guidance technique remains an issue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two cohorts of patients undergoing PFO closure for cryptogenic stroke in two catheterization laboratories of the same institution, using similar inclusion criteria but different guidance, were compared with propensity score matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 374 patients were enrolled, 161 in Angio\u2010group and 213 in Echo\u2010group. No difference was detected in the procedural complication rate. In Angio\u2010group, radiological exposure (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001) and 6\u2010month residual shunt (16.8% vs 8.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.015) were higher. After a mean follow\u2010up of 41\u00a0\u00b1\u00a030\u00a0months, 28 patients (7.5%) presented any adverse event (death, recurrent cerebral ischemia, device\u2010related complications, reintervention), with a higher rate in Angio\u2010group (13.0% vs 3.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), mainly due to repeated percutaneous intervention (10.6% vs 1.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). The results were confirmed after propensity score matching (118\u00a0patients\/group). The rate of recurrent cerebral ischemia was 1.9% and was not significantly different in the two groups. Intra\u2010procedural guidance and atrial septum aneurysm were independent predictors of the composite primary endpoint (OR 1.2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of intra\u2010procedural transesophageal echocardiography (TEE) guidance for PFO closure allows lower residual shunt rate, radiological exposure, and adverse events, mainly driven by a significant reduction in percutaneous reintervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13842","type":"journal-article","created":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T16:49:45Z","timestamp":1519231785000},"page":"834-840","source":"Crossref","is-referenced-by-count":13,"title":["Angiography vs transesophageal echocardiography\u2010guided patent foramen ovale closure: A propensity score matched analysis of a two\u2010center 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M.","family":"Biava","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Department Azienda Ospedaliera Universitaria Citt\u00e0 della Salute e della Scienza di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Matranga","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Department Azienda Ospedaliera Universitaria Citt\u00e0 della Salute e della Scienza di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Biasco","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Department Azienda Ospedaliera Universitaria Citt\u00e0 della Salute e della Scienza di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Omed\u00e8","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Department Azienda Ospedaliera Universitaria Citt\u00e0 della Salute e 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