ArticleEuropean heart journal2024
Embolic strokes of undetermined source: a clinical consensus statement of the ESC Council on Stroke, the European Association of Cardiovascular Imaging and the European Heart Rhythm Association of the ESC.
Article in European heart journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Anticoagulants or antiplatelets for secondary prevention of cryptogenic stroke: an updated systematic review and meta-analysis.Heart (British Cardiac Society) · 2025Pooled it
- Advanced vascular aging and outcomes after acute ischemic stroke: a systematic review and meta-analysis.Journal of human hypertension · 2024Pooled it
- Identifying patients at low risk for atrial fibrillation after cryptogenic stroke: the PAVA score.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Observational
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Diagnostic Yield of Comprehensive Etiologic Evaluation in Young Adults with Ischemic Stroke: Toward a Phenotype-Driven Approach.Journal of clinical medicine · 2026Article
- Lipoprotein(a) Levels and Embolic Stroke of Undetermined Source in Patients with Patent Foramen Ovale.Journal of clinical medicine · 2026Article
- Quantitative Analysis of Pulmonary Right-to-Left Shunts and Patent Foramen Ovale via Agitated Saline Contrast Transesophageal Echocardiography: Associations With Migraine, Cryptogenic Stroke, and Transient Ischemic Attack.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Embolic Stroke of Undetermined Source Following Surgical Atrial Septal Defect Closure with Dacron Patch in a Young Adult without Identifiable Risk Factors.Annals of cardiac anaesthesia · 2026Article
- Clinical phenotypes of ischaemic stroke patients and early cardiovascular complications: a latent class analysis from the Perugia Stroke Registry.Internal and emergency medicine · 2026Article
- Embolic Stroke of Uncommon Causes-A Case Series Report from an Acute Stroke Unit.Life (Basel, Switzerland) · 2026Article
- A rare case of non-obstructed total anomalous pulmonary venous connection with a giant superior vena cava aneurysm complicated by acute young ischemic stroke.BMC cardiovascular disorders · 2026Article
- Myocardial infarction, stroke and arterial stenosis: time to reassess a major misunderstanding.Nature reviews. Cardiology · 2026Review
- Incremental value of characteristics of right-to-left shunt in patients with migraine and cryptogenic stroke via multi-modal echocardiography.Quantitative imaging in medicine and surgery · 2026Article
- Article
- Investigation of Atrial and Ventricular Arrhythmias in Young Ischemic Cerebrovascular Disease Patients.International journal of general medicine · 2026Article
- Association of P-Wave Parameters With Left Atrial Hemodynamics in Atrial Cardiomyopathy.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Impaired left atrial strain is associated with acute ischemic stroke in patients without atrial fibrillation.Frontiers in stroke · 2026Article
- Digital Health-Enabled Monitoring Strategies for Atrial Fibrillation Detection after Embolic Stroke of Undetermined Source: A Cost-Effectiveness Analysis of Implantable Loop Recorders, Wearable Devices, and Usual Care.Cerebrovascular diseases (Basel, Switzerland) · 2025Article
- Cryptogenic stroke: definitions and management.Hematology. American Society of Hematology. Education Program · 2025Review
- ESR Bridges: imaging and management of carotid atherosclerosis through a standardized classification system-a multidisciplinary view.European radiology · 2025Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
One in six ischaemic stroke patients has an embolic stroke of undetermined source (ESUS), defined as a stroke with unclear aetiology despite recommended diagnostic evaluation. The overall cardiovascular risk of ESUS is high and it is important to optimize strategies to prevent recurrent stroke and other cardiovascular events. The aim of clinicians when confronted with a patient not only with ESUS but also with any other medical condition of unclear aetiology is to identify the actual cause amongst a list of potential differential diagnoses, in order to optimize secondary prevention. However, specifically in ESUS, this may be challenging as multiple potential thromboembolic sources frequently coexist. Also, it can be delusively reassuring because despite the implementation of specific treatments for the individual pathology presumed to be the actual thromboembolic source, patients can still be vulnerable to stroke and other cardiovascular events caused by other pathologies already identified during the index diagnostic evaluation but whose thromboembolic potential was underestimated. Therefore, rather than trying to presume which particular mechanism is the actual embolic source in an ESUS patient, it is important to assess the overall thromboembolic risk of the patient through synthesis of the individual risks linked to all pathologies present, regardless if presumed causally associated or not. In this paper, a multi-disciplinary panel of clinicians/researchers from various backgrounds of expertise and specialties (cardiology, internal medicine, neurology, radiology and vascular surgery) proposes a comprehensive multi-dimensional assessment of the overall thromboembolic risk in ESUS patients through the composition of individual risks associated with all prevalent pathologies.
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