Transesophageal Echocardiography in Embolic Stroke of Undetermined Source

Therapeutic Implications of Early Transesophageal Echocardiography in Embolic Stroke of Undetermined Source (ESUS)

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT03107637

Acronym

ETO

Enrollment

186

Registered

2017-04-11

Start date

2016-10-03

Completion date

2019-01-31

Last updated

2021-06-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Embolic Stroke of Undetermined Source, Ischemic Stroke

Keywords

Embolic Stroke of Undetermined Source, transesophageal echocardiography, cardiac source of embolism, ischemic stroke

Brief summary

The ESUS concept was introduced recently to describe a non-lacunar stroke of undetermined etiology. The following etiological workup is required in this setting: head CT or MRI, 12-lead ECG, transthoracic echocardiography, continuous cardiac monitoring for at least 24 hours after stroke, vascular imaging (ultrasound, magnetic resonance angiography, CT angiography, catheter angiography). Transesophageal echocardiography (TEE) is considered not to be required. However, aortic arch atheroma as diagnosed by TEE in the setting of recent ischemic stroke is a major aortic source of embolism, as supported by numerous well conducted studies. The European Association of Echocardiography considers that TEE is the gold standard for the diagnosis and the characterization of aortic atheroma. It is also the method of choice for the diagnosis of infectious endocarditis. The aim of this work was to evaluate the rate of patients with a therapeutic modification induced by TEE (mainly anticoagulation and surgery), in consecutive patients admitted with ESUS at our institution stroke unit.

Interventions

None listed

Study design

Observational model

OTHER

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Presenting with a new onset of ischemic stroke * Meeting the ESUS criteria (Embolic Stroke of Undetermined Source) * Comprehensive transthoracic echo prior to the TEE

Exclusion criteria

* ESUS criteria not met * Contraindications to TEE * TEE failure * Pregnant or breastfeeding woman * Person under legal protection * No medical insurance coverage

Design outcomes

Primary

Measure	Time frame	Description
therapeutic modification after transesophageal echocardiography	24 hours after TEE	proportion of patients with a therapeutic modification (mainly anticoagulation and surgery)

Countries

France

Outcome results