Why the study?
Aortic mural thrombus in the ascending aorta is a rare embolic source, and differences between cardiac CT and CT angiography for its detection were examined.
Does cardiac CT improve the detection of aortic mural thrombus compared to CTA in patients with acute embolic infarction?
Does cardiac CT improve the detection of aortic mural thrombus compared to CTA in patients with acute embolic infarction?
Cardiac CT may be a useful alternative or ancillary tool to TEE for detecting small aortic mural thrombi that are missed by standard CTA in patients with embolic stroke.
Should not yet change TEE-first embolic workup; leaves open cardiac CT as a less-invasive alternative for small mobile AMT.
Aortic mural thrombus (AMT) in the ascending aorta is a rare source of embolism. Recently, the usefulness of contrast computed tomography (CT) has been reported, and we sought to examine the differences between cardiac CT and CT angiography (CTA). A 58-year-old patient of acute embolic infarction was treated by endovascular thrombectomy. Postoperative cardiac CT revealed the AMT as an embolic source. The lesion was not detected by the CTA performed 2 days before. This is the first case report of AMT to highlight the apparent utility of cardiac CT. Although trans-esophageal echocardiogram (TEE) is still the first choice for routine embolic exploration, cardiac CT may play a role as an alternative tool aimed to detect small size AMT.
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Noda et al. (2021) studied this question.
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