Key result
Percutaneous retrieval and anticoagulation resolve early clopidogrel-resistant PFO device thrombosis mimicking infection.
Case Report (n=1)
Early PFO device thrombosis can mimic infection and may be driven by clopidogrel nonresponsiveness, highlighting the value of platelet function testing and percutaneous retrieval.
May aid differentiation of clopidogrel nonresponsiveness from endocarditis post-PFO closure; leaves open need for confirmatory trials before practice change.
Percutaneous patent foramen ovale (PFO) closure lowers recurrent stroke risk but can rarely cause device thrombosis or infection. A 57-year-old woman had elective PFO closure with a GORE CARDIOFORM Septal Occluder device after cerebellar infarction. Despite aspirin and clopidogrel, she developed fever. Transesophageal echocardiography revealed large thrombi on the device. Multidisciplinary management achieved percutaneous retrieval 1-week postimplantation. Cultures were negative. Platelet testing confirmed aspirin effect but showed clopidogrel nonresponsiveness, leading to anticoagulation. Follow-up imaging demonstrated thrombus regression. This case highlights early device thrombosis mimicking infection, successful percutaneous retrieval, and the value of platelet function testing in guiding therapy.
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Hajji et al. (2026) conducted a case report in Device thrombosis after patent foramen ovale (PFO) closure (n=1). Percutaneous retrieval and anticoagulation was evaluated. Early device thrombosis after PFO closure can mimic infection and may be driven by clopidogrel nonresponsiveness, successfully managed with percutaneous retrieval and anticoagulation.
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