Embolic Strokes of Undetermined Source: Key Points
American College of Cardiology
MAY 6, 2024
The following are key points to remember from a European consensus statement on embolic strokes of undetermined source.
Retrograde cerebral embolism and pulmonary embolism caused by patent ductus arteriosus: a case report
Journal of Cardiothoracic Surgery
JUNE 26, 2024
Although rare, paradoxical embolism sometimes occurs with patent ductus arteriosus (PDA). This study presents a case of PDA-associated paradoxical embolism with acute ischemic stroke (AIS) and pulmonary emboli.
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Artificial intelligence predicts undiagnosed atrial fibrillation in patients with embolic stroke of undetermined source using sinus rhythm electrocardiograms
HeartRhythm
MARCH 14, 2024
Artificial intelligence (AI)-enabled sinus rhythm (SR) electrocardiogram (ECG) interpretation can aid in identifying undiagnosed paroxysmal atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS).
PO-04-049 PATIENTS WITH EMBOLIC STROKE OF UNDETERMINED SOURCE MORE LIKELY TO DEVELOP ATRIAL FIBRILLATION COMPARED WITH OTHER CAUSES OF EMBOLIC STROKE
HeartRhythm
APRIL 30, 2024
AF detection rates with implantable cardiac monitoring (ICM) following cryptogenic stroke are >12% at 12 months. Similar results have been reported in some non-cryptogenic stroke cohorts. Real-world data has also shown a much lower rate of AF detection.
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Predictors of atrial fibrillation detection in embolic stroke of undetermined source patients with implantable loop recorder
Frontiers in Cardiovascular Medicine
MARCH 3, 2024
Background Covert atrial fibrillation (AF) is a predominant aetiology of embolic stroke of undetermined source (ESUS). Evidence suggested that AF is more frequently detected by implantable loop recorder (ILR) than by conventional monitoring.
PO-02-173 IMPACT OF ATRIAL FIBRILLATION DETECTED BY CARDIAC IMPLANTABLE ELECTRONIC DEVICES ON EMBOLIC STROKE EVENTS IN CANCER PATIENTS
HeartRhythm
APRIL 30, 2024
The association between AF detected by implanted cardiac implantable electronic devices (CIEDs) and the incidence of embolic stroke has been reported. Moreover, the cut-off value of new-onset AF duration detected by CIEDs for embolic stroke is still unknown.
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Aspiration of thrombus for intermediate-risk subacute pulmonary embolism
Journal of Cardiothoracic Surgery
APRIL 7, 2024
Pulmonary embolism is the most common cardiovascular disease after myocardial infarction and stroke. Konstantinides (Eur Heart J 41(4):543–603, 2020) Current guidelines categorize patients with PE as being at.
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PO-04-089 ATRIAL MECHANICAL REMODELING COULD BE PREDICTABLE FOR NEWLY DEVELOPED ATRIAL FIBRILLATION IN PATIENTS WITH EMBOLIC STROKE WITH UNDETERMINED SOURCE
HeartRhythm
APRIL 30, 2024
Atrial fibrillation (AF) has been known as a main cause of embolic stroke. Well-chosen candidate to be anticoagulated should be critical for secondary prevention in patients with embolic stroke with undetermined source (ESUS).
Stroke reduction by cerebral embolic protection devices in transcatheter aortic valve implantation: a systematic review and Bayesian meta-analysis
Heart BMJ
MAY 10, 2024
Objectives The use of cerebral embolic protection (CEP) during transcatheter aortic valve implantation (TAVI) has been studied in several randomised trials. We aimed to perform a systematic review and Bayesian meta-analysis of randomised CEP trials, focusing on a clinically relevant reduction in disabling stroke.
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Abstract TP259: Slower Early Mitral Inflow Velocity and Lesion in Anterior Circulation is Associated With Right-to-Left Shunt in Embolic Stroke of Undetermined Source Right-to-Left Shunt in Embolic Stroke of Undetermined Source
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page ATP259-ATP259, February 1, 2024. Background and Purpose:Right-to-left shunt (RLS) is one of the potential embolic sources in embolic stroke of undetermined source (ESUS), but the eligibility of conducting shunt study to detect RLS in ESUS is still unknown. cm/s, p = 0.021).
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Evidence and Mechanisms for Embolic Stroke in Contralateral Hemispheres From Carotid Artery Sources
Journal of the American Heart Association
NOVEMBER 28, 2023
BackgroundDisambiguation of embolus pathogenesis in embolic strokes is often a clinical challenge. One common source of embolic stroke is the carotid arteries, with emboli originating due to plaque buildup or perioperatively during revascularization procedures.
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Abstract TP223: Predicting Atrial Fibrillation in Embolic Stroke of Unknown Source
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page ATP223-ATP223, February 1, 2024. Background:A considerable portion of patients with embolic stroke of unknown source(ESUS)are later found to have occult atrial fibrillation (AF).
Abstract 42: Validation of a New Plaque-RADS Classification System to a Cohort of Embolic Stroke of Undetermined Source Patients
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page A42-A42, February 1, 2024. Introduction:A new Plaque-RADS classification (I-IV) is proposed to categorize the degree of carotid plaque instability and risk of embolic ischemic stroke. Carotid total plaque thickness and ulceration were scored by a neuroradiologist blinded to stroke side.
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Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Review of Established and Emerging Embolic Agents
Stroke: Vascular and Interventional Neurology
AUGUST 24, 2023
Stroke: Vascular and Interventional Neurology, Ahead of Print. Middle meningeal artery embolization is an increasingly common procedure involved in the treatment of chronic subdural hematoma (cSDH) that can be an adjuvant intervention or an alternative to traditional medical or surgical therapies.
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40 Clinical Outcomes of Percutaneous Transcatheter Release of Stuck Mechanical Mitral Valve With Cerebral Embolic Protection
Circulation: Cardiovascular Interventions
JUNE 10, 2024
We reported the feasibility and short-term outcomes of percutaneous transcatheter therapy with cerebral embolic protection. During the follow-up, 12.50% (n=3) all-cause death, 4.17% (n=1) stroke, and 16.67% (n=4) recurrence were seen. 1273.47) days, stroke was 1211.38 (95% CI, 1110.40–1312.35)
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The efficacy of different types of cerebral embolic protection device during transcatheter aortic valve implantation: a meta-analysis
Frontiers in Cardiovascular Medicine
FEBRUARY 22, 2024
Aims Perioperative stroke remains a devastating complication after transcatheter aortic valve implantation (TAVI), and using a cerebral embolic protection device (CEPD) during TAVI may reduce the occurrence of stroke according to some studies. The risk of stroke was lower in the CEPD group: RR 0.68, 95% CI 0.49–0.96,
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Brain-Protected TAVR Results in Fewer Real-World Disabling Strokes
Med Page Today
JUNE 5, 2024
(MedPage Today) -- NEW YORK CITY -- Researchers eked out evidence of a small clinical benefit with the Sentinel cerebral embolic protection (CEP) device in transcatheter aortic valve replacement (TAVR) -- and pointed to the patients more likely.
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Current status of ECMO for massive pulmonary embolism
Frontiers in Cardiovascular Medicine
DECEMBER 20, 2023
Massive pulmonary embolism (MPE) carries significant 30-day mortality and is characterized by acute right ventricular failure, hypotension, and hypoxia, leading to cardiovascular collapse and cardiac arrest. Considerable heterogeneity in studies is a significant weakness of the available literature.
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Abstract 139: Super Distal Access using the Vecta46 Intermediate Catheter in Embolization of the MMA for cSDH
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. IntroductionThere is increasing literature to support the efficacy of middle meningeal artery (MMA) embolization in the treatment of chronic subdural hematomas (cSDH). Techniques for optimal embolization of the MMA are yet to be elucidated.
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Role of Cerebral Embolic Protection Devices in Patients Undergoing Transcatheter Aortic Valve Replacement: An Updated Meta?Analysis
Journal of the American Heart Association
JANUARY 19, 2024
BackgroundCerebral embolic protection devices (CEPD) capture embolic material in an attempt to reduce ischemic brain injury during transcatheter aortic valve replacement. Primary clinical outcome was all‐cause stroke. Secondary clinical outcomes were disabling stroke and all‐cause mortality.
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Transcatheter PFO closure for cryptogenic stroke: current approaches and future considerations
Frontiers in Cardiovascular Medicine
MAY 19, 2024
Although generally considered a benign anatomic variant, a PFO may facilitate passage of a thrombus from the venous to arterial circulation, thereby resulting in cryptogenic stroke or systemic embolization.
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Abstract 137: Management of cSDH with the Use of 10:1 Glue Hyper?Dilution in MMA Embolization: Radiographic Follow?up
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. IntroductionMiddle meningeal artery (MMA) embolization for the treatment of chronic subdural hematomas (cSDH) is becoming an alternative to surgical intervention. Bilateral embolization was performed in 91% (n=21) of patients.
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Abstract 028: Chronic Subdural Hematoma Treatment with Embolization Versus Surgery Study Protocol
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. Middle meningeal artery embolization (MMAE) is a promising minimally invasive alternative with an estimated surgical recurrence rate of 6.8% However, surgical drainage is associated with a 15% reoperation rate and a mortality of up to 10%.
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40 PO-04-052 A POLYGENIC RISK SCORE PREDICTS FUTURE ATRIAL FIBRILLATION-RELATED STROKE/SYSTEMIC EMBOLISM
HeartRhythm
APRIL 30, 2024
Polygenic risk score (PRS) might be useful in predicting atrial fibrillation (AF)-related stroke/systemic embolsim (SSE) before diagnosis of clinical AF.
HonorHealth Research Institute First in Southwest to Implant New Stroke Prevention Stent
DAIC
JUNE 4, 2024
The Neuroguard Integrated Embolic Protection (IEP) system is an experimental treatment for carotid artery stenosis, also known as carotid artery disease, a condition in which fatty-waxy deposits known as plaque builds up and blocks the normal flow of blood in the large arteries on either side of the neck.
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111 Abstract 101: Ophthalmic Artery Aneurysm Embolization Resulting in Resolution of Headaches and Visual Symptoms
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. Rarely, thrombus formation within an aneurysm can lead to symptoms via distal embolization and infarction. IntroductionCerebral aneurysms are a rare cause of headaches and visual symptoms.
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Novel electrocardiographic classification for stroke prediction in atrial fibrillation patients undergoing cardioversion
HeartRhythm
APRIL 24, 2024
Abnormal conduction, structure and function of the atrial myocardium predispose to atrial fibrillation (AF) and stroke. Usefulness of electrocardiographic (ECG) indices in predicting stroke or systemic embolism (SSE) in patients undergoing cardioversion for AF remains unknown, especially in those at low estimated risk.
Abstract 111: Woven Endo Bridge?Coil Embolization of a Middle Cerebral Artery Bifurcation Aneurysm with Secondary Lobule
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. The Woven EndoBridge (WEB) is an ellipsoid embolization device designed to provide intrasaccular flow disruption along the aneurysm neck, which has been proven to be an effective method in treating a wide spectrum of wide‐necked bifurcation aneurysms.
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Abstract 088: Treatment of a Ruptured AVM with Inflow Aneurysms: Mixed approach using coil and liquid embolization
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. The inflow aneurysms were accessed and embolized with coils using a second microcatheter prior to AVM embolization. Embolization of three posterior feeding pedicles was subsequently performed utilizing dilute NBCA.
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40 PO-03-081 LEFT ATRIAL FUNCTION AND POLYGENIC RISK SCORES FOR PREDICTING ATRIAL FIBRILLATION AND RELATED STROKE/SYSTEMIC EMBOLISM
HeartRhythm
APRIL 30, 2024
Clinical, imaging, and genetic markers in combinations might be useful for risk assessment of atrial fibrillation (AF) and related stroke/systemic embolsim (SSE).
ARCADIA Trial on Atrial Cardiopathy and Stroke
All About Cardiovascular System and Disorders
FEBRUARY 19, 2024
In an earlier post on Embolic Stroke of Undetermined Source (ESUS) , I had mentioned about ARCADIA trial (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke) which was testing whether there is role for apixaban compared to aspirin for prevention of recurrent stroke in ESUS. 2023.27188.
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52 Abstract WP324: MCA/FeCl3Thromboembolic Model, an Easily Reproducible Model for COVID-19-Induced Embolic Cerebrovascular Complications
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page AWP324-AWP324, February 1, 2024. COVID-19 neurological complications such as strokes and cognitive impairment have been reported. In conclusion, the MCA/FeCl3thromboembolic model is an easily reproducible mouse model to examine COVID-19-induced stroke and cerebrovascular complications.
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Stroke Prevention in Atrial Fibrillation: Our Current Failures and Required Research
Stroke Journal
DECEMBER 21, 2023
Stroke, Volume 55, Issue 1 , Page 214-225, January 1, 2024. Nonvalvular atrial fibrillation is a common rhythm disorder of middle-aged to older adults that can cause ischemic strokes and systemic embolism.
Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation
The New England Journal of Medicine
NOVEMBER 11, 2023
In a randomized trial involving patients with subclinical (typically asymptomatic) atrial fibrillation, apixaban led to a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding.
Link Between Clonal Hematopoiesis and Stroke in Carotid Stenosis
All About Cardiovascular System and Disorders
MAY 22, 2024
About a fifth of all ischemic strokes are attributed to embolization of ruptured atherosclerotic plaque from carotid arterial stenosis. But it has been difficult to predict which person with asymptomatic carotid artery stenosis is likely to progress to symptomatic carotid disease and stroke.
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ISC 2024 News: Late-Breaking Science Findings from EMBOLISE Clinical Trial Reveals Blocking Artery Supplying the Brain Covering After Subdural Hematoma Reduced Repeat Surgery
DAIC
FEBRUARY 9, 2024
Preliminary late-breaking science presented today, the final day of the American Stroke Association’s International Stroke Conference 2024, ISC 2024, focused on findings from the EMBOLISE clinical trial, presented by Jason Davies, M.D., of patients who had surgery plus embolization and 11.3% The conference was held Feb.
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115 Abstract 97: Acute Ischemic Stroke Despite Anticoagulant Use: The Neuro-AFib Study
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page A97-A97, February 1, 2024. vs 19.6%, p=0.002) and a past-history of stroke/TIA (36% vs 25%, p<0.001) when compared to non-AC group. Chronic embolic (non-lacunar) infarcts on imaging were more common among AIS-despite-AC (34.5% Patients who had AIS-despite-AC were younger (76.8+11
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40 Abstract 64: Biomarkers of Atrial Cardiopathy and Outcomes After Cryptogenic Stroke: The ARCADIA Trial
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page A64-A64, February 1, 2024. Background:Atrial cardiopathy is associated with incident ischemic stroke in the absence of clinical atrial fibrillation in prospective cohorts. Recurrent stroke occurred in 80 patients (annualized rate, 4.4%) and death in 54 patients. female, 21.1% Black, and 8.1%
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Stroke and Bleeding Risks of Endocardial Ablation for Ventricular Arrhythmias
American College of Cardiology
FEBRUARY 23, 2024
What is the incidence of the embolic and bleeding complications in relation to pre- and post- periprocedure antithrombotic regimens in patients undergoing ventricular arrhythmia radiofrequency ablation (RFA)?
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Abstract TP320: The Novel Potent Complement C3a Receptor (C3aR) Antagonist JR14a Confers Robust Neuroprotection in Stroke
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page ATP320-ATP320, February 1, 2024. Background:The complement C3a receptor (C3aR) plays a prominent role in deleterious post-stroke neuroinflammation. Additional work is warranted to investigate the neuroprotective properties of JR14a in stroke.
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OCEANIC-AF: Asundexian vs. Apixaban in Patients With AFib
American College of Cardiology
SEPTEMBER 1, 2024
Asundexian was associated with a higher incidence of stroke or systemic embolism, but less major bleeding, compared with apixaban among patients with atrial fibrillation (AFib) who were at high risk for stroke, based on findings from the OCEANIC-AF trial presented at ESC Congress 2024 in London and simultaneously published in The New England Journal (..)
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45 Abstract 089: A Case of Complicated Dissection: Vertebral Artery Sacrifice for Recurrent Stroke Prevention
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. IntroductionPosterior circulation strokes account for 20% of ischemic strokes (1). Optimal management for posterior circulation strokes has been studied less than for anterior circulation strokes (2). hours prior to arrival.
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Schizophrenia and Types of Stroke: A Mendelian Randomization Study
Journal of the American Heart Association
FEBRUARY 29, 2024
BackgroundPrevious studies suggest an association between schizophrenia and stroke, but no studies have investigated stroke subtypes. Little evidence of associations with the other stroke subtypes was found. Journal of the American Heart Association, Ahead of Print.
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