Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots

This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appendage, once around a pacemaker lead in the right atrium, and once in the left atrial appendage (Figures 2B,C). Four patients were classified as ESUS (Table 2; mean age 80 years, standard deviation 2.7 years; 25% female). Irregular and ulcerating plaques were found in the proximal ascending aorta of two of these patients (Figure 2D). FIGURE 2 Figure 2. (A) Scout-view showing scan range of conventional (1,2) and extended (1–4) angiography; (3) corresponds to panel (B). Axial CT images: (B) thrombotic material in appendage of left atrium (LA) in patient 15; (C) thrombus around pacemaker lead in right atrium (RA) in patient 17; (D) ulcerating plaque in ascending aorta (AAo) in patient with ESUS. TABLE 1 Table 1. Patients with ischemic stroke and atrial fibrillation. TABLE 2 Table 2. Patients with embolic stroke of undete...
Source: Frontiers in Neurology - Category: Neurology Source Type: research