The diagnostic yield of transesophageal echocardiography in patients with cryptogenic cerebral ischaemia: a meta‐analysis

Abstract

Routine TEE in patients with cryptogenic IS/TIA commonly identifies abnormal findings. However, the prevalence of cardiac conditions considered to be causally associated with cerebral ischaemia (intracardiac thrombi and tumors) is low.

Transcranial Doppler versus transthoracic echocardiography for the detection of patent foramen ovale in patients with cryptogenic cerebral ischemia: A systematic review and diagnostic test accuracy meta‐analysis

“…Patent foramen ovale (PFO) can be detected in up to 43% of patients with cryptogenic cerebral ischemia undergoing investigation with transesophageal echocardiography (TEE) . PFOs discovered in patients with cryptogenic stroke are more likely to be etiologically associated to the index event, probably via paradoxical embolism, if the patient is younger and without conventional vascular risk factors .…”

Cardioembolic Stroke: Mechanisms and Therapeutics

“…21,22 A meta-analysis examining the diagnostic yield of TEE in cryptogenic stroke found that while abnormalities are often discovered, most commonly aortic arch atheroma and PFO, cardiac abnormalities that are causally linked to stroke is quite low and would not necessarily lead to a change in secondary stroke prevention strategries. 23 As such, in most cases, TTE is typically preferable as it is noninvasive, safer, less expensive, more widely available, and patient management decisions are not influenced in the vast majority of cases. 24 Cardiac magnetic resonance (CMR) imaging is increasingly being recognized as a viable, noninvasive diagnostic tool in evaluating cardiac structure in cases of ischemic stroke.…”

Neues beim Schlaganfall

“…Der diagnostische Nutzen der transösophagealen Echokardiografie (TEE) bei Patienten mit Schlaganfall unklarer Ursache ist unklar und wird seit Jahren kritisch diskutiert. In einer aktuellen systematischen Metaanalyse wurden Daten von 5772 Patienten aus insgesamt 35 Studien zu Befunden der Echokardiografie bei kryptogenem Schlaganfall ausgewertet [9]. Dabei zeigten sich häufig auffällige Befunde in der TEE, am häufigsten atherosklerotische Plaques in Aorta ascendens oder Aortenbogen (51 %) und ein persistierendes Formalen ovale (43 %).…”