Early transoesophageal echocardiography in cryptogenic and lacunar stroke and transient ischaemic attack

Censori, B.; Colombo, Francesco; Valsecchi, M. G.; Clivati, L.; Zonca, A.; Camerlingo, M.; Casto, L.; Tommasi, M; Mamoli, A

doi:10.1136/jnnp.64.5.624

Cited by 20 publications

(21 citation statements)

References 34 publications

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“…A total of 260 articles were identified in the initial search, of which 27 (n = 5,653) met our eligibility criteria, [23][24][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40][41]7,[42][43][44][45]11,[46][47][48][49][50][51][52] including 18 subcohorts in group A (b55 years, n = 2,360) and 20 subcohorts in group B (≥55 years or age unselected, n = 3,293). online Appendix Supplementary Table II summarizes the characteristics of the study populations.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies (n = 591) reported on the proportion of patients who were commenced on oral anticoagulant therapy following the results of TEE, including 0%, 37 2.3%, 11 6.0%, 43 11.0%, 23 and 30.7% 24 of patients. Left atrial thrombus, SEC, PFO, PFO with ASA, and aortic plaques were the most commonly reported indications for introduction of oral anticoagulation after TEE results.…”

Section: Change In Management Based On Tee Findingsmentioning

confidence: 99%

“…26,27,37,11 Two studies reported on the interrater reliability for cardiac findings detected by TEE. 28,7 Disagreement between echocardiographers on the presence or absence of a PFO ranged from 7.8 % 7 to 13.9%, 28 and from 1.6% 7 to 6.6% 28 for the presence or absence of an ASA.…”

Section: Complications Of Teementioning

confidence: 99%

See 2 more Smart Citations

Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

McGrath

Paikin

Motlagh

et al. 2014

American Heart Journal

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Section: Resultsmentioning

confidence: 99%

Section: Change In Management Based On Tee Findingsmentioning

confidence: 99%

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Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

McGrath

Paikin

Motlagh

et al. 2014

American Heart Journal

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“…Immediate echocardiography yields a low incidence of findings: In 65 patients with cryptogenic stroke, TIA, or lacunar stroke, TEE performed within 3 days of presentation yielded an atrial thrombus in 1 patient, and 5 had spontaneous echo contrast. 160 The echocardiographic method used is important. TEE is more sensitive than TTE for atheroma of the aortic arch and abnormalities of the interatrial septum (eg, atrial septal aneurysm, PFO, atrial septal defect), atrial thrombi, and valvular disease.…”

Section: Cardiac and Other Testingmentioning

confidence: 99%

Definition and Evaluation of Transient Ischemic Attack

Easton

Saver²,

Albers³

et al. 2009

Stroke

1,563

563

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Abstract-Thishours of symptom onset, preferably with magnetic resonance imaging, including diffusion sequences; noninvasive imaging of the cervical vessels should be performed and noninvasive imaging of intracranial vessels is reasonable; electrocardiography should occur as soon as possible after TIA and prolonged cardiac monitoring and echocardiography are reasonable in patients in whom the vascular etiology is not yet identified; routine blood tests are reasonable; and it is reasonable to hospitalize patients with TIA if they present within 72 hours and have an ABCD 2 score Ն3, indicating high risk of early recurrence, or the evaluation cannot be rapidly completed on an outpatient basis. Key Words: AHA Scientific Statements Ⅲ brain Ⅲ brain ischemia Ⅲ cerebral ischemia Ⅲ ischemia Ⅲ stroke Ⅲ transient ischemic attack Ⅲ acute stroke syndromes Ⅲ acute cerebrovascular syndromes R ecent scientific studies have revised our understanding of 3 key aspects of transient ischemic attack (TIA): how it is best defined, what the early risk of stroke and other vascular outcomes is, and how it is best evaluated. This statement reviews and synthesizes recent scientific advances regarding the definition, urgency, and evaluation of TIA and is designed to aid the clinician in the short-and long-term management of patients with TIA. DefinitionTIAs are brief episodes of neurological dysfunction resulting from focal cerebral ischemia not associated withThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on January 16, 2009. A copy of the statement is available at http://www.americanheart.org/presenter.jhtml?identifierϭ3003999 by selecting either the "topic list" link or the "chronological list" link (No. LS-2037). To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Expert peer review of AHA Scientific Statements is conducted at the AHA National Center. For more on AHA statements and guidelines development, visit http://www.americanheart.org/presenter.jhtml?identifierϭ3023366.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml?identifierϭ4431. A link to the "Permission Request Form" appears on the right side of the page.© 2009 American Heart Association, Inc. UrgencyLarge cohort and population-based studies reported in the last 5 years have demonstrated a higher risk ...

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“…Knowledge of the relationship between echocardiographic smoke and intracardiac thrombus and the nature of the smoke may help the management of patients with cerebral embolism when the need for anticoagulant or antiplatelet aggregatory agent is to be considered. 11 While the association between ischemic stroke and cardiac thrombi and spontaneous echo contrast has been under investigation, [12][13][14][15] several methods have been used to investigate the pathogenesis of spontaneous contrast. 2,5,16 In the previous studies, although blood stasis, 16 platelet aggregation, 17 red blood cell (RBC) coagulation, 18 and flow-related interaction of RBCs and plasma have been implicated in such echogenicity, the mechanism responsible for the formation of echocardiographic smoke is still not fully understood.…”

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confidence: 99%

Identification Of Echocardiographic “Smoke” in a Bench Model With Transcranial Doppler Ultrasound

Yang

Grosset

Qiu

et al. 2000

Stroke

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Background and Purpose-Spontaneous echo contrast in cardiac chamber has been indicated as a source of cerebral embolism. The nature of the echocardiographic smokelike signal is still not fully understood. This study was designed to regenerate spontaneous echo contrast and verify its thromboembolic characters in an in vitro model. Methods-Spontaneous echo contrast was reproduced in an expansion chamber under low flow conditions in a close circulation system. The spontaneous echo contrast was monitored and recorded with a 2-dimensional cardiosonography system and a transcranial Doppler device. Meanwhile, clinically commonly encountered embolic materials such as whole-blood clots, platelet aggregate-rich plasma, air bubbles, and 100-mL normal saline were injected into this monitored circuit. The differentiation of spontaneous echo contrast from emboli was performed by both visual observations of the echo images and offline Doppler signal intensity analysis. Average signal intensities produced by spontaneous contrast and injection of embolic materials and saline were compared. Furthermore, the effect of Doppler-detected flow velocity on generation of spontaneous contrast was also evaluated. Results-Spontaneous echo contrast was reproduced at low flow settings (90 to 120 mL/min) in this model. There was no significant difference in average signal intensity between the flow with spontaneous echo contrast and that without the echo (Pϭ0.71). However, injection of embolic materials or normal saline did not generate smokelike image but caused much higher average signal intensity than the flow with spontaneous contrast (PϽ0.001). Injection of normal saline also increased average signal intensity. Conclusions-Our results suggest that smokelike echo is a special echo phenomenon occurring at low flow situations and does not itself produce material capable of embolizing into the systemic circulation. (Stroke. 2000;31:907-914.)

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Early transoesophageal echocardiography in cryptogenic and lacunar stroke and transient ischaemic attack

Cited by 20 publications

References 34 publications

Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

Definition and Evaluation of Transient Ischemic Attack

Identification Of Echocardiographic “Smoke” in a Bench Model With Transcranial Doppler Ultrasound

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