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.
Embolism Stroke Strokes 
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).
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.
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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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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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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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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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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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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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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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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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.
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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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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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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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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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).
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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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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Case Report: Hypereosinophilic syndrome vs. patent foramen ovale as etiopathogenetic contributors to stroke
Frontiers in Cardiovascular Medicine
JANUARY 11, 2024
Patent foramen ovale (PFO) is the most common congenital intracardiac defect that can cause right-to-left shunting and contribute to the paradoxical embolization of venous emboli, and even lead to stroke. We report the case of a young man who presented with cerebral infarction accompanied by both HES and PFO.
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59 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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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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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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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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Drug therapies for stroke prevention
The British Journal of Cardiology
NOVEMBER 29, 2023
Stroke is a major cause of mortality, morbidity and economic burden. Strokes can be thrombotic, embolic or haemorrhagic. The key risk factor for cardioembolic stroke is atrial fibrillation or flutter, and oral anticoagulation (OAC) is recommended in all but the lowest-risk patients with evidence of these arrhythmias.
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Epidemiology, Pathophysiology, and Imaging of Atherosclerotic Intracranial Disease
Stroke Journal
JANUARY 21, 2024
Stroke, Volume 55, Issue 2 , Page 311-323, February 1, 2024. Intracranial atherosclerotic disease (ICAD) is one of the most common causes of stroke worldwide. In addition to stroke, ICAD increases the risk of dementia and cognitive decline, magnifying ICAD societal burden.
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RapidAI Announces Late-Breaking Abstract Simultaneously Published in NEJM; Highlights Key Data Revealed at ISC 2024
DAIC
FEBRUARY 13, 2024
Other select data from research studies unveiled last week at the American Heart Association ’s International Stroke Conference (ISC) underscore and reinforce the pivotal role of the RapidAI platform in advancing stroke care. Improved Stroke Outcomes Following Implementation of RapidAI Platform at Ascension-Illinois, by Malisch et.
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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.
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.
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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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.
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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The ABC?Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study
Journal of the American Heart Association
FEBRUARY 14, 2024
BackgroundThe ABC‐stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). Having an annual ABC‐stroke risk >1% was associated with stroke/SE, stroke/SE/cardiovascular death, and all‐cause death (hazard ratio, 1.82 [95% CI, 1.44–2.21],
Mass screening for atrial fibrillation does not prevent stroke in older adults, research finds
Medical Xpress - Cardiology
SEPTEMBER 3, 2024
Mass screening for atrial fibrillation using ECG together with heart failure biomarker does not prevent ischemic stroke or systemic embolism (blood clot) in older adults aged 75–76 years over 5 years follow-up, according to late breaking research presented in a Hot Line Session at this year's ESC Congress 2024 in London, UK (30 Aug–2 Sept).
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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Preoperative management and anticoagulant efficacy in atrial myxoma-associated acute ischemic stroke: a case report and literature review
Frontiers in Cardiovascular Medicine
NOVEMBER 12, 2024
Acute ischemic stroke (AIS) is a common complication of atrial myxoma (AM), and most emboli originate from a thrombus attached to the surface of the myxoma, with occasional shedding of tumor fragments leading to stroke. Clinical manifestations of AM include mitral valve obstruction, systemic embolism, and weakness.
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40 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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Parabiosis Discriminates the Circulating, Endothelial, and Parenchymal Contributions of Endogenous Tissue-Type Plasminogen Activator to Stroke
Stroke Journal
JANUARY 30, 2024
Stroke, Ahead of Print. BACKGROUND:Intravenous injection of alteplase, a recombinant tPA (tissue-type plasminogen activator) as a thrombolytic agent has revolutionized ischemic stroke management. However, when associated to tPAWTlittermates, tPANullmice had similar perfusion deficits, but less severe brain infarcts.
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40 High Prevalence of New Clinically Significant Findings in Patients With Embolic Stroke of Unknown Source Evaluated by Cardiac Magnetic Resonance Imaging
Journal of the American Heart Association
JANUARY 19, 2024
BackgroundEmbolic stroke of unknown source (ESUS) accounts for 1 in 6 ischemic strokes. Journal of the American Heart Association, Ahead of Print.
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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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