Liu Jie, Liu Yehong, Sheng Ying, Ye Jiangping, Yuan Rikang, Wang Xiao, Zong Gangjun
Department of Cardiology, No. 904 Hospital of the PLA Joint Logistics Support Force, Wuxi, China.
Front Neurol. 2025 Jul 22;16:1618910. doi: 10.3389/fneur.2025.1618910. eCollection 2025.
Patent foramen ovale (PFO), present in 20-30% of the population, was once considered benign but is now recognized as a contributor to cryptogenic stroke and other clinical syndromes. Recent randomized trials and updated guidelines have established PFO closure as an effective intervention, leading to a surge in research. This study uses bibliometric analysis to evaluate global research trends, collaborations, and emerging hotspots in PFO closure.
We analyzed 927 English-language articles (2004-2024) from the Web of Science Core Collection using bibliometric tools (VOSviewer, CiteSpace, Bibliometrix R, online bibliometric analysis platforms). We systematically examined publication trends, contributions by countries and institutions, author networks, journal influence, and keyword clusters.
Annual publications increased significantly after 2017, coinciding with pivotal trial results. The United States (34.6%), Italy (16.8%), and Germany (11.5%) led in research output. Key institutions (e.g., University of Bern) and prominent authors (e.g., Meier Bernhard) played central roles. Four major research clusters were identified: mechanisms of paradoxical embolism, diagnostic imaging (e.g., transesophageal echocardiography), closure techniques (e.g., Amplatzer devices), and clinical outcomes. Burst detection revealed evolving priorities, including post-closure atrial fibrillation and improved patient selection (e.g., RoPE score).
Research on PFO closure has progressed from pathophysiological understanding to evidence-based clinical intervention, driven by landmark trials and multidisciplinary collaboration. Future directions include optimizing patient selection, managing post-procedural complications, and expanding indications (e.g., migraine). This analysis offers a roadmap for advancing stroke prevention strategies related to PFO.
卵圆孔未闭（PFO）在20% - 30%的人群中存在，曾被认为是良性的，但现在被认为是不明原因卒中及其他临床综合征的一个促成因素。近期的随机试验和更新的指南已将PFO封堵确立为一种有效的干预措施，导致研究激增。本研究使用文献计量分析来评估全球PFO封堵的研究趋势、合作情况和新兴热点。
我们使用文献计量工具（VOSviewer、CiteSpace、Bibliometrix R、在线文献计量分析平台）分析了来自科学网核心合集的927篇英文文章（2004 - 2024年）。我们系统地研究了发表趋势、国家和机构的贡献、作者网络、期刊影响力以及关键词聚类。
2017年后年度发表量显著增加，与关键试验结果一致。美国（34.6%）、意大利（16.8%）和德国（11.5%）在研究产出方面领先。关键机构（如伯尔尼大学）和杰出作者（如迈尔·伯恩哈德）发挥了核心作用。确定了四个主要研究集群：反常栓塞机制、诊断成像（如经食管超声心动图）、封堵技术（如Amplatzer装置）和临床结果。突发检测揭示了不断变化的重点，包括封堵术后房颤和改善患者选择（如RoPE评分）。
在具有里程碑意义的试验和多学科合作的推动下，PFO封堵研究已从病理生理理解发展到基于证据的临床干预。未来的方向包括优化患者选择、处理术后并发症以及扩大适应症（如偏头痛）。该分析为推进与PFO相关的卒中预防策略提供了路线图。
