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Updates on Prevention of Cardioembolic Strokes

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机构: [a]Department of Neurology, Hacettepe University, Ankara, Turkey [b]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [c]Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea [d]Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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关键词: Ischemic stroke Cardioembolism Atrial fibrillation Anticoagulants Left atrial appendage closure Patent foramen ovale closure

摘要:
Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism. The non-vitamin K antagonist oral anticoagulants have improved our ability to prevent strokes for many patients with non-valvular atrial fibrillation (NVAF). Advances in left atrial appendage closure and the U.S. Food and Drug Administration approval of the WATCHMAN (Boston Scientific) device for stroke prevention in NVAF patients who have an appropriate rationale for a nonpharmacological alternative, have revolutionized the field and provided a viable option for patients at higher hemorrhagic risk. The role of patent foramen ovale closure for secondary prevention in selected patients experiencing cryptogenic ischemic strokes at a relatively young age has become clearer thanks to the very recent publication of long-term outcomes from three major studies. Advances in the management of infective endocarditis, heart failure, valvular diseases, and coronary artery disease have significantly changed the management of such patients, but have also revealed new concerns related to assessment of ischemic versus hemorrhagic risk in the setting of antithrombotic use. The current review article aims to discuss these advances especially as they pertain to the stroke neurology practice.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外周血管病
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 临床神经病学 2 区 外周血管病
JCR分区:
出版当年[2016]版:
Q1 PERIPHERAL VASCULAR DISEASE Q1 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [a]Department of Neurology, Hacettepe University, Ankara, Turkey
通讯作者:
通讯机构: [d]Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA [*1]Department of Neurology, Massachusetts General Hospital, Hemorrhagic Stroke Research Program, 175 Cambridge Street, Suite 300, Boston, MA 02114, USA
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