ArticleInternational journal of stroke : official journal of the International Stroke Society2024
Non-ECG-gated cardiac CT angiography in acute stroke is feasible and detects sources of embolism.
Article in International journal of stroke : official journal of the International Stroke Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Patients With Acute Ischemic Stroke (AIS of HEARTS).Stroke · 2026Pooled it
- Extended CTA scan range for early detection of left atrial and left atrial appendage thrombus and other filling defects in acute ischemic stroke.Journal of neurology · 2026Article
- Cardiac photon-counting detector computed tomography in acute ischemic stroke: diagnostic accuracy for detection of left atrial appendage thrombus.Therapeutic advances in neurological disorders · 2026Article
- Focused cardiac ultrasound conducted by neurologists in patients with stroke: A validation study.European stroke journal · 2026Article
- Frequency and management of non-cardiac incidental findings on cardiac CT in patients with a suspected stroke.European stroke journal · 2026Article
- Nongated Photon-Counting Computed Tomography Angiography Detects Cardioembolic Stroke Sources and Thoracic Pathology: A Retrospective Cohort Study.Stroke (Hoboken, N.J.) · 2025Article
- Evaluation of AI-based detection of incidental pulmonary emboli in cardiac CT angiography scans.The international journal of cardiovascular imaging · 2025Article
- Cardiac CT in Large Vessel Occlusion Stroke for the Evaluation of Non-Thrombotic and Non-Atrial-Fibrillation-Related Embolic Causes.Neurology international · 2025Article
- Artificial intelligence-powered solutions for automated aortic diameter measurement in computed tomography: a narrative review.Annals of translational medicine · 2024Review
- Association between Left Atrial Appendage Morphology and Clot Histology in Patients with Embolic Ischemic Stroke: An Exploratory Study.Journal of clinical medicine · 2024Article
- Cardiac thrombus detected by cardiac computed tomography angiography in patients with acute ischemic stroke: a meta-analysis.Frontiers in neurology · 2024Article
- Intra-cardiac thrombus detection by electrocardiogram-gated cardiac computed tomography in hyperacute ischemic stroke.Frontiers in neurologyArticle
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA significant portion of cryptogenic stroke is hypothesized to be secondary to cardiac embolism. However, transthoracic echocardiogram is usually delayed after stroke, and more detailed cardiac imaging is not routinely done.
aimsThis study aimed to determine whether non-ECG-gated cardiac CT angiography (cCTA) during hyperacute stroke would provide diagnostic quality images and act as an adjunct modality of cardiac imaging to detect sources of emboli.
methodsIn this single-center prospective cohort study, modified Code Stroke imaging was implemented with a 64-slice CT scanner, where the longitudinal axis of CT angiography was extended from the carina to the diaphragm. The primary outcomes of image quality, recruitment feasibility, impact on hyperacute time metrics, and additional radiation dose were assessed. Secondary outcomes consisted of detection of high-risk cardiac sources of embolism, mediastinal or lung pathology, and impact on etiologic classification.
resultsOne hundred and twenty eligible patients were enrolled, of which 105 (87.5%) had good/moderate quality images for motion artifact and 119 (99.2%) for contrast opacification. Total CT time, door-to-needle time, and door-to-groin puncture time were unchanged with the addition of cCTA. Eighty-nine patients received a final diagnosis of ischemic stroke, of which 12/89 (13.5%) had high-risk cardioembolic findings on cCTA. Incidental findings, such as pulmonary embolism (PE) (7/89, 7.9%) and malignancy (6/89, 6.7%), were observed. cCTA led to changes in management for 19/120 (15.8%) of all patients, and reclassification of stroke etiology for 8/89 (9%) of patients.
conclusionsNon-ECG-gated cCTA can be feasibly incorporated into Code Stroke and provide diagnostic quality images without delays in hyperacute time metrics. It can detect high-risk cardiac sources, and other findings impacting patient care. This may help reclassify a subset of cryptogenic stroke cases and improve secondary prevention.
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