Key result
Abnormal endocardium and smaller PFO tunnel area linked to in situ thrombus, found in ~63% of patients.
Why the study?
In situ thrombus formation is a key pathogenesis of patent foramen ovale (PFO)-related disorders, motivating this exploration of factors contributing to in situ thrombus in affected patients.
Observational (n=46)
OCT imaging reveals that endocardial abnormalities and a smaller minimal PFO-tunnel area are independently associated with in situ thrombus formation in patients with PFO-related disorders.
BACKGROUND: In situ thrombus formation represents one of the key pathogeneses of patent foramen ovale (PFO)‑related disorders. This study aimed to explore factors contributing to in situ thrombus in patients with PFO‑related diseases. AIMS: This study aimed to explore factors contributing to in situ thrombus in patients with PFO-related diseases. METHODS: Forty‑six prospectively enrolled patients with PFO‑related disorders underwent OCT imaging to explore potential contributing factors for in situ thrombus. None of the enrolled participants presented with concomitant lower‑extremity venous thrombosis or atrial fibrillation, and no alternative pathogenic factors were detected. RESULTS: In 63.04% of the cases (29 individuals), an in situ thrombus was present in the PFO tunnel. Patients with in situ thrombus exhibited a notably smaller right PFO area and minimum area, along with a higher incidence of abnormal endocardium than those without thrombus. Multivariate logistic regression analysis identified PFO minimum area and abnormal endocardium as independent factors associated with in situ thrombus. CONCLUSIONS: Our exploratory analysis suggests that endocardial abnormality and a smaller minimal PFO‑tunnel area may correlate with a higher risk of thrombus formation, offering clues regarding possible mechanisms behind PFO‑related diseases.
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Liu et al. (2026) conducted an observational in Patent foramen ovale (PFO)-related disorders (n=46). OCT-detected abnormal endocardium and smaller minimal PFO-tunnel area vs. Normal endocardium and larger minimal PFO-tunnel area (patients without in situ thrombus) was evaluated on In situ thrombus formation in the PFO tunnel. Abnormal endocardium and smaller minimal PFO-tunnel area on OCT were independently associated with in situ thrombus, which occurred in 63.04% (29/46) of patients with PFO-related disorders.
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