Detecting Cardiac Thrombi in Acute Ischemic Stroke on Cardiac CT Versus Transoesophageal Echocardiography

Launched by ACADEMISCH MEDISCH CENTRUM - UNIVERSITEIT VAN AMSTERDAM (AMC-UVA) · Sep 3, 2024

Keywords

ClinConnect Summary

This clinical trial is studying the best way to detect blood clots in the heart, specifically in patients who have had an ischemic stroke, which is caused by a blockage in blood flow to the brain. Researchers want to see if using a type of heart scan called cardiac CT can find these clots better than the current method, which is a procedure called transoesophageal echocardiography (TEE). The trial will help determine whether cardiac CT can detect clots that may disappear soon after a stroke, which TEE might miss.

To be eligible for the study, participants must be at least 18 years old and have a recent diagnosis of acute ischemic stroke with a blood clot found on their initial cardiac CT scan. After giving consent, participants will undergo the TEE test for research purposes, which involves some risks but is generally safe. Those who join the study will be monitored over time to see how effective these tests are in detecting heart clots. It's important to note that some patients may have difficulty giving consent due to their condition, and in those cases, a legal representative can provide consent instead.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age 18 years or older
• • Clinical diagnosis of acute ischemic stroke
• • Written informed consent from patient or representative
• • Radiological diagnosis of cardiac thrombus in the LA, including the LAA, on cardiac CT acquired during the initial stroke imaging protocol.
• Exclusion Criteria:
• • Patients with a diagnosis other than acute ischemic stroke, such as: transient ischemic attack, intracerebral haemorrhage, subarachnoid haemorrhage, epilepsy, tumor.
• * Absolute contraindication for TEE:
• • Perforated viscus
• • Esophageal stricture
• • Esophageal tumor
• • Esophageal perforation, laceration
• • Esophageal diverticulum
• • Active upper GI bleed
• • Absolute contraindication for repeat cardiac CT
• • Documented previous severe reaction to iodinated contrast media, including anaphylaxis, angioedema and bronchospasm.
• • Severely impaired kidney function defined as estimated glomerular filtration rate of 30 mL/min/1.73 m2.