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Stroke Echoscan Protocol: A Fast and Accurate Pathway to Diagnose Embolic Strokes
Author(s) -
Pagola Jorge,
GonzálezAlujas Teresa,
Muchada Marian,
Teixidó Gisela,
Flores Alan,
De Blauwe Sophie,
Seró Laia,
Luna David Rodríguez,
Rubiera Marta,
Ribó Marc,
Boned Sandra,
ÁlvarezSabin José,
Evangelista Arturo,
Molina Carlos A.
Publication year - 2014
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12139
Subject(s) - medicine , stroke (engine) , embolic stroke , cardiology , etiology , acute stroke , cohort , radiology , surgery , ischemic stroke , tissue plasminogen activator , mechanical engineering , ischemia , engineering
BACKGROUND AND PURPOSE Cardiac Echoscan is the simplified transthoracic echocardiogram focused on the main source of emboli detection in the acute stroke diagnosis (Stroke Echoscan). We describe the clinical impact related to the Stroke Echoscan protocol in our Center. METHODS Acute stroke patients who underwent the Stroke Echoscan by a trained stroke neurologist were included (Echoscan group). All examinations were reviewed by cardiologists. The main embolic stroke etiologies were: ventricular akinesia (VA), severe aortic atheroma (AA) plaque and cardiac shunt (SHUNT). The rate of the embolic stroke etiologies and the median length of stay (LOS) were compared with a cohort of patients studied by cardiologist (Echo group). RESULTS Eighty acute stroke patients were included. The sensitivity (S) and specificity (E) were: VA ( S 98.6%, E 66.7%, k = .7), AA ( S 93.3%, E 96.9%, k = .88) and SHUNT ( S 100%, E 100%, k = 1), respectively. The rate of AA diagnosis was significantly higher in Echoscan group (18.8% vs. 8.9%; P = .05). Echoscan protocol significantly reduced the LOS: 6 days (IQR 3‐10) versus Echo group 9 days (IQR 6‐13; P < .001). CONCLUSION The Echoscan protocol was an accurate quick test, which reduced the length of stay and increased the percentage of severe AA plaque diagnosis.