Embolic Stroke

An ischemic stroke due to a blood clot, emboli or other types of blockage which forms somewhere other than the brain and subsequently travels near and restricts blood flow to the brain. Most often the origin of the clot is from the heart and is referred to as cardioembolic stroke.

Also Known As:

Networked: 1428 relevant articles (115 outcomes, 250 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Stroke (Strokes)
2.	Atrial Fibrillation
3.	Ischemic Stroke
4.	Infarction (Infarctions)
5.	Thrombosis (Thrombus)

Experts

1.	Chopp, Michael: 41 articles (01/2021 - 04/2002)
2.	Zhang, Li: 37 articles (01/2021 - 04/2002)
3.	Hart, Robert G: 26 articles (06/2022 - 05/2003)
4.	Zhang, Zheng Gang: 26 articles (01/2021 - 04/2002)
5.	Lapchak, Paul A: 24 articles (01/2016 - 05/2002)
6.	Lu, Mei: 21 articles (01/2021 - 05/2002)
7.	Mundl, Hardi: 19 articles (05/2022 - 09/2016)
8.	Ntaios, George: 19 articles (01/2022 - 01/2016)
9.	Uchiyama, Shinichiro: 19 articles (07/2021 - 11/2006)
10.	Jiang, Quan: 18 articles (01/2021 - 05/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Embolic Stroke:

1.	AnticoagulantsIBA 02/23/1995 - "Anticoagulants are highly effective for preventing cardioembolic stroke, but their effectiveness in non-cardioembolic stroke is uncertain because of lack of trial data. " 01/01/2021 - "Direct oral anticoagulants (DOACs) have proven efficacy to prevent cardioembolic strokes. " 01/01/2021 - "A trial fibrillation (AF) increases cardio-embolic stroke risk, yet AF diagnosis and subsequent prophylactic anticoagulant prescription rates are suboptimal globally. " 04/01/2015 - "Direct anticoagulants are being evaluated in randomized controlled trials including embolic stroke of undetermined source patients. " 02/01/2007 - "We performed an updated meta-analysis of all randomized trials to obtain the best estimates of the efficacy and safety of anticoagulants for the initial treatment of acute cardioembolic stroke. "
2.	Tissue Plasminogen Activator (Alteplase)FDA Link 03/01/2012 - "We present a case of a fully anti-coagulated 29-month-old supported on a Berlin EXCOR LVAD (Berlin, Germany) with embolic stroke which was treated successfully with direct thrombolysis with recombinant tissue plasminogen activator. " 01/01/2000 - "Magnetic resonance imaging indexes of therapeutic efficacy of recombinant tissue plasminogen activator treatment of rat at 1 and 4 hours after embolic stroke." 11/15/2018 - "Protective effects of 2-(2-benzonfuranyl)-2-imidazoline combined with tissue plasminogen activator after embolic stroke in rats." 11/01/2010 - "Improved functional outcomes after alteplase administration have been shown in clinical trials, along with improved histological and behavioral measures in experimental models of embolic stroke. " 01/01/2020 - "Following embolic stroke in male C57bl/6 mice, thrombolysis using tissue-plasminogen activator (t-PA) reduced injury and improved motor deficits, but did not improve cognitive outcomes. "
3.	Warfarin (Coumadin)FDA LinkGeneric 10/01/2019 - "Warfarin loading dose guided by pharmacogenetics is effective and safe in cardioembolic stroke patients - a randomized, prospective study." 10/01/2019 - "Warfarin loading dose guided by pharmacogenetics after recent cardioembolic stroke improved the efficacy of warfarin initiation without increasing the risk of adverse events." 04/01/2012 - "This study was designed to investigate a novel device that was developed to direct emboli away from the internal carotid artery to the external carotid artery to prevent embolic stroke while avoiding the necessity for anticoagulation with warfarin. " 01/01/2017 - "The medical records of 177 cardioembolic stroke patients who were taking warfarin between April, 2008 and March, 2015 were retrospectively analyzed. " 01/01/2017 - "Embolic stroke of undetermined source (ESUS) was diagnosed and warfarin was administered. "
4.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 06/01/1995 - "In this study we examined the effects of aspirin on the rate of clot lysis and on the frequency and extent of hemorrhagic transformations in rabbit models of embolic stroke. " 01/01/2020 - "Aspirin remains the standard antithrombotic treatment for patients with embolic stroke of undetermined source. " 01/01/2019 - "Because of a patient who had embolic stroke while on therapeutic aspirin dose but in whom aspirin resistance was present on his thromboelastography platelet mapping, we chose to obtain thromboelastography platelet mapping on cardiac patients on aspirin to assess their risk. " 12/01/2015 - "Acetylsalicylic acid is the most common antithrombotic given to patients with embolic strokes of undetermined source to reduce recurrence risk. " 06/01/2008 - "Aspirin resistance was greater in lacunar than embolic strokes (platelet activation 79% versus 59%, P=0.020). "
5.	Heparin (Liquaemin)FDA LinkGeneric 08/01/2010 - "The efficacy of early anticoagulation after cardioembolic stroke in relation to outcome has not been assessed adequately, but there is evidence from animal models and clinical studies that anticoagulation with unfractionated heparin is associated with a better outcome mediated in part by its anti-inflammatory properties." 07/01/2011 - "Blood samples were obtained from patients included in the Heparin in Acute Embolic Stroke Trial. " 04/08/2000 - "Heparin in Acute Embolic Stroke Trial." 07/01/1997 - "As regards prevention of early recurrence, most authors agree that heparin is indicated in cardioembolic stroke." 04/24/1993 - "In the case of cardio-embolic stroke, heparin should be started after 48 hours. "
6.	Hydroxymethylglutaryl-CoA Reductase Inhibitors (HMG-CoA Reductase Inhibitors)IBA 01/01/2021 - "Several real-world observational studies have investigated the association between statin treatment and outcomes of cardioembolic stroke. " 01/01/2021 - "The Effect of Statin Treatment on Outcomes of Cardioembolic Stroke: A Systematic Review and Meta-Analysis of Real-World Studies." 02/01/2020 - "This study aimed to investigate the effect of statins on the neurological outcomes after a cardioembolic stroke. " 02/01/2015 - "Cardioembolic stroke in the THRombolysis and STatins (THRaST) study." 11/07/2023 - "Effectiveness of statins on outcomes of patients with Embolic Stroke of Undetermined Source (ESUS)."
7.	Platelet Aggregation Inhibitors (Antiplatelet Drugs)IBA 09/01/2009 - "In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. " 06/01/2018 - "Because antiplatelet agents are much less effective in preventing cardioembolic stroke, it is now more prudent to anticoagulate patients in whom cardioembolic stroke is strongly suspected. " 07/01/2022 - "Methods We retrospectively evaluated 12 patients diagnosed with a cardioembolic stroke who took any DOAC without an antiplatelet drug and underwent platelet aggregation tests within 60 days from the onset of symptoms. " 01/01/2022 - "Patients in whom a cardioembolic source is strongly suspected should be anticoagulated; antiplatelet agents are not significantly safer than DOACs, and are not effective in cardioembolic stroke." 07/01/2014 - "Antiplatelet agents are administered to avoid non-cardioembolic stroke. "
8.	Clopidogrel (Plavix)FDA Link 01/01/2023 - "Clopidogrel is prescribed to people who have had a non-cardioembolic stroke. " 01/01/2012 - "Clopidogrel could thus be useful as first line secondary prevention therapy in all non-cardioembolic stroke subtypes and transient ischaemic attacks, to prevent recurrent ischaemic events in all vascular territories." 04/03/2023 - "Patients with stroke are at a high risk of recurrence, and although they receive antiplatelet therapies such as clopidogrel for secondary prevention of non-cardioembolic stroke, the recurrence rate remains high. " 02/15/2017 - "We aimed to investigate whether smoking status has a differential impact on the efficacy of clopidogrel vs. aspirin in patients with non-cardioembolic strokes. " 04/01/2018 - "A noninferiority confirmatory trial of prasugrel versus clopidogrel in Japanese patients with non-cardioembolic stroke: rationale and study design for a randomized controlled trial - PRASTRO-I trial."
9.	Biomarkers (Surrogate Marker)IBA 07/01/2021 - "Etiological investigation for cardioembolic stroke has benefited in the last years from information provided by studies analysing serum biomarkers, heart rhythm monitoring and imaging methods like cardiovascular magnetic resonance (CMR) imaging. " 01/01/2020 - "The aim of this study was to obtain the candidate genes and biomarkers that are significantly related to cardioembolic stroke (CS) by applying bioinformatics analysis. " 01/01/2019 - "The study is aimed at identifying echocardiographic and circulating biomarkers as well as hemodynamic indices of embolic stroke of undetermined etiology (ESUS) in patients aged <65. " 01/01/2019 - "In a prospective study among patients in the THRombectomie des Artères Cerebrales trial, we analyzed the diagnostic accuracy of 2 imaging biomarkers, the 2-layered susceptibility vessel sign and a high overestimation ratio, obtained on pretreatment brain T2* sequences, to identify cardioembolic stroke etiology (107/260 patients). " 05/01/2009 - "Few studies have examined the relationship between inflammatory biomarker blood levels, cardioembolic stroke subtype and neurological deficit. "
10.	DabigatranFDA Link 09/20/2023 - "She had a history of embolic stroke of undetermined sources at the age of 40, and underwent implantable cardiac monitor implantation and had started dabigatran. " 11/15/2014 - "Cardioembolic stroke in a patient taking Dabigatran Etexilate: the first case report of clinical and pharmacologic resistance." 12/01/2012 - "The lower risk of sICH under dabigatran etexilate compared with VKA treatment may facilitate early initiation of OAC after cardioembolic stroke." 03/01/2012 - "Dabigatran in the preventive treatment of embolic stroke: arguments against its utilisation as a first-choice drug]." 03/01/2012 - "Dabigatran in the preventive treatment of embolic stroke: arguments in favour of its utilisation as a first-choice drug]."

Therapies and Procedures

1.	Therapeutics 04/01/1998 - "and i.v. therapy with prourokinase are equally effective in promoting reperfusion and inhibiting the development of focal ischemic injury in this rat embolic stroke model." 10/01/2023 - "TARDIS was an international prospective randomised open-label blinded-endpoint trial assessing one month of intensive versus guideline antiplatelet therapy in patients with acute non-cardioembolic stroke or TIA. " 01/01/2023 - "In the absence of robust trial, an Expert Consensus was reached recommending long-term antiplatelet therapy in non-haemorrhagic MMA, as it may reduce risk of embolic stroke. " 01/01/2022 - "Recent randomized controlled trials found no beneficial effect of DOAC therapy in unselected patients with embolic stroke of undetermined source (ESUS). " 12/01/2021 - "In this study, we investigate the combined effect of delayed tPA therapy and PC procedure during an embolic stroke experimental model in female rats. "
2.	Secondary Prevention 07/01/2019 - "Although antiplatelet treatments are most often used for secondary prevention of embolic stroke of undetermined source, optimal strategies remain unclear. " 08/01/2019 - "Although traditional experts still opine for the use of antiplatelets for secondary prevention of ESUS as for other causes of embolic stroke, there are still room for improvement in delivery of optimal treatment strategy. " 01/01/2023 - "Secondary prevention of cardioembolic stroke requires long-term anticoagulation. " 01/01/2023 - "Embolic Stroke of Undetermined Source: Role of Implantable Loop Recorder in Secondary Prevention." 09/01/2022 - "Embolic stroke of undetermined source (ESUS) is a common medical challenge regarding secondary prevention strategy. "
3.	Thrombolytic Therapy 03/01/1994 - "The efficacy of thrombolytic therapy for treatment of embolic stroke has been a subject of both experimental and clinical examination. " 11/01/1990 - "Early fibrinolytic therapy improved outcome in this model of acute embolic stroke." 02/01/1995 - "This preliminary study appears to suggest that intra-arterial local fibrinolytic therapy could be a new strategy for acute embolic stroke." 09/01/2023 - "She accidentally developed an acute embolic stroke but fully recovered due to emergent thrombolytic therapy. " 01/01/2015 - "Platelet rich clots are resistant to lysis by thrombolytic therapy in a rat model of embolic stroke."
4.	Thrombectomy 01/15/2021 - "However, recent evidence shows that mechanical thrombectomy is also effective and safe in patients with cardioembolic stroke. " 01/15/2021 - "All randomized controlled trials that evaluated the efficacy and safety of mechanical thrombectomy in the treatment of cardioembolic stroke will be included. " 01/15/2021 - "Therefore, the aim of this study is to evaluate the efficacy and safety of mechanical thrombectomy for cardioembolic stroke. " 01/15/2021 - "Previous studies have shown that mechanical thrombectomy in cardioembolic stroke with intracranial large artery occlusion has a poor prognosis. " 11/15/2023 - ": While embolic stroke management in these cases remains difficult as patients are usually anticoagulated, our case demonstrates the utilization of endovascular thrombectomy as a viable therapeutic option in the setting of an uncommon occurrence of embolic stroke in the hours following LVAD implantation."
5.	Lasers (Laser) 02/01/1991 - "Significant heating (0.5 degree C or more) of the blood occurred only with laser powers higher (1,600 mW/cm2) or laser irradiations longer (25 minutes) than those used in the improved model of embolic stroke. " 08/01/2004 - "This study shows that laser treatment improved behavioral performance if initiated within 6 hours of an embolic stroke and the effect of laser treatment is durable. " 03/24/2011 - "Mean microvessel segment length and radius after embolic stroke: Comparison of magnetic resonance imaging (MRI) and laser scanning confocal microscopy (LSCM)." 02/01/2009 - "Laser Doppler flowmetry (LDF) is increasingly used to assess adequate occlusion after embolic stroke (ES) in rats. " 02/01/2009 - "Laser Doppler flowmetry predicts occlusion but not tPA-mediated reperfusion success after rat embolic stroke."