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.
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).
Embolic risk management in infective endocarditis: predicting the 'embolic roulette
Open Heart
JANUARY 31, 2025
Life-threatening complications of infective endocarditis (IE,) are heart failure, uncontrolled infection and embolic events (EE), which pose significant morbidity and mortality risks. Depending on the location and severity of the embolism, the embolic risk can either escalate or alternatively, complicate and delay cardiac surgery.
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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.
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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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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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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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-04-049 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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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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Abstract TP388: Integrating standard-of-care clinical stroke workup within in silico embolic stroke models for etiology disambiguation
Stroke Journal
JANUARY 30, 2025
Stroke, Volume 56, Issue Suppl_1 , Page ATP388-ATP388, February 1, 2025. Introduction:Embolic Stroke of Undetermined Source (ESUS) accounts for a critical proportion of all ischemic strokes. Disambiguating embolism etiology is important to improve treatment efficacy and reduce recurrent events.
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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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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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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.
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).
Avicenna.AI Secures FDA Clearance for Two Healthcare AI Solutions
DAIC
MARCH 26, 2024
Addressing the serious issue of delayed and missed findings in diagnostic imaging, CINA-iPE is an AI-powered tool that detects incidental pulmonary embolism during routine CT scans. This is particularly relevant in the cancer patient population, where pulmonary embolism is a significant cause of mortality.
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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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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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Novartis Reclaims Anthos, Reenters Factor XI Race
CardiacWire
FEBRUARY 12, 2025
Bayer terminated its OCEANIC-AF trial for its Factor XI inhibitor, asundexian, due to 3x greater stroke (1.3% vs. 0.4%) and 4x higher ischemic stroke rates (csHR = 4.06). Results from BMS AXIOMATIC-SSP study found that its Factor XI inhibitor, milvexian, failed to meaningfully reduce ischemic stroke.
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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 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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ECG Cases 45 ECG in Weakness and Neurological Symptoms
ECG Cases
SEPTEMBER 12, 2023
The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.
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Abstract WP214: Embolization in Chronic Subdural Hematomas
Stroke Journal
FEBRUARY 1, 2024
Stroke, Volume 55, Issue Suppl_1 , Page AWP214-AWP214, February 1, 2024. Introduction:Middle meningeal artery embolization for chronic subdural hematomas is a promising treatment either as an adjuvant to surgical evacuation of the hematoma or as a primary treatment modality. The mean maximal diameter of the collection was 16.3 ± 6.6
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Asundexian versus Apixaban in Patients with Atrial Fibrillation
The New England Journal of Medicine
JANUARY 1, 2025
A randomized trial of the factor XIa inhibitor asundexian was stopped early owing to a higher incidence of stroke or systemic embolism than with apixaban therapy among patients with atrial fibrillation.
Anticoagulants for atrial fibrillation: from warfarin and DOACs to the promise of factor XI inhibitors
Frontiers in Cardiovascular Medicine
FEBRUARY 4, 2024
Anticoagulation is the mainstay of stroke prevention in appropriate patients with atrial fibrillation. An investigational class of agents which inhibit Factor XI have shown promise in pre-clinical and early clinical trials to significantly minimize bleeding while maintaining efficacy against stroke and systemic embolism.
Abstract WMP98: Use of Direct Oral Anticoagulants (DOACs) Compared to Aspirin for Secondary Prevention of Embolic Stroke of Undetermined Source (ESUS): A Systematic Review and Meta-analysis.
Stroke Journal
JANUARY 30, 2025
Stroke, Volume 56, Issue Suppl_1 , Page AWMP98-AWMP98, February 1, 2025. Background:The use of oral anticoagulation (OAC) for stroke prevention in embolic stroke of undetermined source (ESUS) is hypothesized to be beneficial over conventional antiplatelet use. A random-effects model was used for the analyses. RevMan Web).Results:14,582
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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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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).
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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Abelacimab Stops Bleeding, But Stroke Impact Uncertain
CardiacWire
JANUARY 24, 2025
Fully published results from Athos Therapeutics AZALEA-TIMI 71 trial for its novel Factor XI inhibitor abelacimab, confirming the drugs lower bleeding risks, but leaving researchers uncertain about its ability to prevent stroke in AFib patients. vs. 0.4%) and 4X ischemic stroke rates (csHR = 4.06). year follow-up. per 100 person-year.
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59 Abstract TP262: Fibrocartilaginous embolism: a rare cause of ischemic myelopathy
Stroke Journal
JANUARY 30, 2025
Stroke, Volume 56, Issue Suppl_1 , Page ATP262-ATP262, February 1, 2025. Introduction:Fibrocartilaginous embolism (FCE) is a rare etiology of spinal cord infarction that occurs when nucleus pulposus material from intervertebral discs spontaneously embolizes into a spinal artery.
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Abstract WP251: Middle meningeal artery embolization using Onyx and particles for chronic subdural hematoma: A single center experience.
Stroke Journal
JANUARY 30, 2025
Stroke, Volume 56, Issue Suppl_1 , Page AWP251-AWP251, February 1, 2025. Middle meningeal artery (MMA) embolization is being utilized more frequently as adjunctive and primary treatment. Here, we present the outcomes of this technique with different embolic agents in our patient population.IRB approval was obtained for this study.
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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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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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52 Stroke PROTECTion With SEntinel During Transcatheter Aortic Valve Replacement
American College of Cardiology
OCTOBER 29, 2024
The goal of the PROTECTED TAVR trial was to evaluate the efficacy of intraprocedural cerebral embolic protection (CEP) in reducing strokes among patients undergoing transfemoral TAVR for aortic stenosis.
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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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Abstract 4141940: Outcomes in Middle Eastern Atrial Fibrillation Patients with Prior Ischemic Stroke/Systemic Embolism: Findings from the JoFib Study
Circulation
NOVEMBER 11, 2024
Patients with a history of prior hemorrhagic stroke were excluded from this analysis. Circulation, Volume 150, Issue Suppl_1 , Page A4141940-A4141940, November 12, 2024.
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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40 Abstract TP324: Lupus Anticoagulant Is Associated With Acute Recurrence in Cardiogenic Embolic Stroke in Older Patients
Stroke Journal
JANUARY 30, 2025
Stroke, Volume 56, Issue Suppl_1 , Page ATP324-ATP324, February 1, 2025. Background and Purpose:Antiphospholipid antibody syndrome (APS) is a rare cause of cerebral infarction, but the effect of antiphospholipid antibodies (aPL) on the acute phase of ischemic stroke in each stroke subtypes is still unclear, especially in the elderly 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 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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Direct Oral Anticoagulants Compared With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease Without Mechanical Valves
Journal of the American Heart Association
FEBRUARY 14, 2025
The primary effectiveness outcomes were ischemic stroke or systemic embolism, and bleeding for safety. In the matched cohort, DOAC use (versus warfarin) was associated with a lower rate of ischemic stroke or systemic embolism (HR, 0.70 [95% CI, 0.610.81]) and bleeding (HR, 0.72 [95% CI, 0.650.80]).
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