Evidence map›Paper›PMID 39845932›Full record

ArticleFrontiers in neurology2024

Suprasternal aortic arch echocardioscopy as a potential tool in detection and follow-up of mobile thrombi in patients with ischemic stroke.

Inhar Esnaola Barriola, Elena Escriche Gorospe, Paula Miguel Navas, Elisa Martínez Campos, María Molina Goicoechea, Ferran Capell Pascual, Adrián Jiménez Delgado, Roberto Muñoz Arrondo

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Article in Frontiers in neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Inhar Esnaola Barriola *Neurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Elena Escriche Gorospe *Neurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Paula Miguel NavasNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Elisa Martínez CamposNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
María Molina GoicoecheaNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Ferran Capell PascualNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Adrián Jiménez DelgadoNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.
Roberto Muñoz ArrondoNeurology Department, Navarre University Hospital, Pamplona, Navarra, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Severe or complicated atheromatosis of the aortic arch represents an important and often underdiagnosed embolic source in patients with ischemic stroke. The presence of a floating thrombus has significant clinical relevance, as it is associated with a high risk of early recurrence. The aim of this study was to analyze the potential of echocardiographic examination through the suprasternal window in both the detection of embolic sources and the monitoring of the response to anticoagulant treatment in patients with mobile thrombi. Methods: This case series study included ten consecutive patients with a mobile floating aortic arch thrombus associated with an atheromatous plaque, detected by focused echocardiography and confirmed by Computed Tomography Angiography (CTA). Epidemiological, clinical, radiological, and ultrasound characteristics were analyzed. Clinical and ultrasound follow-up was performed after initiation of anticoagulation as secondary prevention to assess the efficacy and safety of this treatment. Results: Ten patients (seven female) with a mean age of 76 years were identified. After anticoagulation, a complete resolution of the mobile thrombus was observed in eight of them during ultrasound follow-up. One patient suffered an ischemic recurrence. Two patients receiving associated antiplatelet therapy presented severe hemorrhagic complications, one of which was fatal. Once the disappearance of the mobile thrombus was detected, anticoagulation was discontinued, and no further ischemic recurrences were observed. Discussion: Floating thrombus of the aortic arch is an underdiagnosed but clinically relevant condition. The study of the aortic arch with echocardiography through the suprasternal window is a highly available and harmless technique, that may be highly useful for the detection and monitoring of response to treatment of this pathology. Furthermore, early anticoagulation could be an effective and safe treatment in these patients.

Indexed as

anticoagulationaortic archechocardioscopyischemic strokemobile thrombussuprasternal

Identifiers

PMID39845932
PMCPMC11752908

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