2020
DOI: 10.1111/jon.12721
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Transcranial Doppler Emboli Monitoring for Infective Endocarditis

Abstract: BACKGROUND AND PURPOSEIschemic stroke can occur in 20‐55% of patients with infective endocarditis (IE) with 75% occurring during the first 2 weeks of treatment. CT or MRI brain can diagnose the sequelae of stroke but transcranial Doppler (TCD) can document active embolization. We undertook a retrospective review of our patient cohort and a systematic review of literature to assess the role of TCD in early diagnosis and management of ischemic stroke in IE.METHODSRetrospective chart review and literature review.… Show more

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Cited by 4 publications
(7 citation statements)
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“…TCD/TCCS can play several roles in evaluation and management and, may complement MRI in the diagnosis of apparent asymptomatic patients. Studies assessing correlation of HITS with occurrence of stroke have found the prevalence of HITS to be highest in patients with IE [3]. Results showed that neurological complications occurred in 83% of patients with HITS compared to 33% of patients without HITS (P = 0.021).…”
Section: Transcranial Doppler (Tcd/tccs): Active Embolization Monitoring Rolementioning
confidence: 96%
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“…TCD/TCCS can play several roles in evaluation and management and, may complement MRI in the diagnosis of apparent asymptomatic patients. Studies assessing correlation of HITS with occurrence of stroke have found the prevalence of HITS to be highest in patients with IE [3]. Results showed that neurological complications occurred in 83% of patients with HITS compared to 33% of patients without HITS (P = 0.021).…”
Section: Transcranial Doppler (Tcd/tccs): Active Embolization Monitoring Rolementioning
confidence: 96%
“…Patients found with HITS on TCD/TCCS have 2.5 times higher incidence of stroke, compared with patients without HITS, also have been associated with higher mortality [3]. The presence of HITS in IE patients with no neurological manifestations may suggest the need for early initiation of therapy (e.g., antibiotics) in high clinical suspicion of IE, but no documentation of vegetation or evaluation for more aggressive therapies like valvular surgery or vacuum-assisted vegetation extraction.…”
Section: Transcranial Doppler (Tcd/tccs): Active Embolization Monitoring Rolementioning
confidence: 99%
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“…In der neurologischen Notfallmedizin stellen MES ein Maß für das Makroembolierisiko nach akuten Insulten durch symptomatische ACI-Stenosen dar [75] Bei intrakraniellen Stenosen sind MES in der Akutsituation vor allem auf einen rekanalisierenden Embolus hinweisend und weniger auf eine hochaktive intrakranielle Stenose [75]. Nach kardialer Embolie bei persistierendem Foramen ovale (PFO) und Vorhofflimmern spielt die MES-Detektion aufgrund der geringen Anzahl von MES pro Untersuchung praktisch keine Rolle, jedoch kann die Mikroembolidetektion bei der Diagnostik und Therapie infektiver und nicht-infektiver Endokarditiden nützlich sein [79,80].…”
Section: Mikroemboliedetektionunclassified