Fragmental or Massive Embolization in Cardiogenic Stroke Caused by Nonvalvular Atrial Fibrillation

Sadahiro, Hirokazu; Inamura, Akinori; Ishihara, Hideyuki; Kunitsugu, Ichiro; Goto, Hisaharu; Oka, Fumiaki; Shirao, Satoshi; Yanagawa, Hiroshi; Wada, Yasuaki; Suzuki, Michiyasu

doi:10.1016/j.jstrokecerebrovasdis.2012.09.006

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…In comparison to other non-cardiogenic brain ischaemic events, AF-related strokes often result in a severe clinical course, higher mortality, and significantly greater post-stroke disability [2,3]. Besides the clinically-confirmed brain ischaemic event in the population of AF patients, at least 15% of subjects exhibit clinically-silent foci (silent strokes) in neuroimaging [4].…”

Section: Introductionmentioning

confidence: 99%

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

et al. 2016

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A b s t r a c t Background:The main goal of treatment in patients with atrial fibrillation is to counteract the effects of embolisation, considering the relatively high risk of cerebral embolic events.Aim: An assessment of the efficacy and safety of rivaroxaban in secondary stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Methods:The study concerned 209 NVAF patients (male/female: 117/92; mean age 65.3 years ), who used rivaroxaban as secondary prevention of cardiogenic stroke. The patients were followed up for 24 months: the control visits were performed 12 and 24 months after the onset of the inclusion. The following aspects were analysed: the occurrence of recurrent stroke and/or transient ischaemic attack (TIA) during rivaroxaban treatment, bleeding episodes with their placement and severity assessment, drug tolerance, and evaluation of the patient's medical records including laboratory tests (e.g. creatinine clearance) and concomitant therapy. All patients underwent physical examination as well as neurological assessment. Results:The mean CHA 2 DS 2 -VASc in the study group was 4.16, and the mean HAS-BLED value was 3.31. During the follow-up 13 deaths were noted (6.22%), ischaemic stroke was diagnosed in five (2.39%) subjects, and TIA in three (1.43%) patients. Bleeding complications were reported in 25 (11.96%) patients, two of which were classified as major bleedings (0.95%): an intracranial bleeding (1) and a bleeding from the genital tract (1). Conclusions:For patients with NVAF and cerebrovascular events, the use of rivaroxaban in a real-world clinical setting results in a highly efficacious treatment profile and acceptable safety.

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Section: Introductionmentioning

confidence: 99%

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

et al. 2016

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“…On the other hand, bilateral occlusion of the middle cerebral arteries usually results from cardiac disease, e.g. atrial fibrillation with or without atrial thrombus [4]. Clinically this condition presents with bilateral paresis, coma, and decerebrate rigidity related to sudden global ischemia.…”

Section: Discussionmentioning

confidence: 99%

Sudden Coma from Acute Bilateral M1 Occlusion: Successful Treatment with Mechanical Thrombectomy

2014

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We report a case with acute small infarct of the left middle cerebral artery in a 72-year-old man with atrial fibrillation documented by MRI and MR angiography. One hour later, he lost consciousness and CT with CT angiography revealed bilateral hyperdense middle cerebral arteries due to occlusion of the M1 segments. Mechanical thrombectomy of the right middle cerebral artery was successfully performed. During that time, thrombosis on the left side had progressed to carotid T occlusion, which was recanalized as well. The patient had a good outcome with slight aphasia and mild paresis of the left hand and could be transferred to rehabilitation 2 weeks later.

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“…In the diagnosis and treatment of patients with Af and LVH, clinicians should consider whether intracardiac emboli may have occluded the carotid arteries. In their study of cardioembolic stroke due to non-valvular atrial fibrillation, Sadahiro et al reported that patients with distal artery occlusion had a significantly higher rate of detection of left atrial thrombus than those with more proximal main trunk occlusion [19]. They concluded that fragmental embolization is associated with distal artery occlusion, and therefore, remnant emboli in the left atrium are more commonly detected.…”

Section: Association Of a Huge Embolus With A Heart Diseasementioning

confidence: 99%

Emergent cervical surgical embolectomy for extracranial internal carotid artery occlusion

Kiyofuji¹,

Inoue²,

Tamura³

et al. 2015

Acta Neurochir

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Fragmental or Massive Embolization in Cardiogenic Stroke Caused by Nonvalvular Atrial Fibrillation

Cited by 4 publications

References 31 publications

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

Sudden Coma from Acute Bilateral M1 Occlusion: Successful Treatment with Mechanical Thrombectomy

Emergent cervical surgical embolectomy for extracranial internal carotid artery occlusion

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