{"id":"6f2ac43935cc","type":"article","url":"https://hartvaat.nl/2026/02/24/uitgebreid-cta-bereik-detecteert-vroegtijdig-thrombus-in-het-linker-atrium-bij-a/","title":"Uitgebreid CTA-bereik detecteert vroegtijdig thrombus in het linker atrium bij acute CVA","title_en":"Extended CTA scan range for early detection of left atrial and left atrial appendage thrombus and other filling defects in acute ischemic stroke.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Journal of neurology","doi":"10.1007/s00415-026-13692-6","source_url":"https://doi.org/10.1007/s00415-026-13692-6","authors":["Juan Marta-Enguita","Sara Biain","Diego Ayuso","Sergio Vasquez-Ferreccio","Cristina Del Bosque","Patricia de la Riva","Noemí Diez","Felix Gonzalez","Ana de Arce","Jon Equiza","Gorka Arenaza","Virginia Gomez-Usabiaga","Maite Martinez-Zabaleta"],"significance":5,"published":"2026-02-24","source_date":"2026-02-24","image":"https://hartvaat.nl/global/img/629f64045fcb.webp","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/"],"congress":"","summary_en":"By extending CT angiography scan range to include the left atrium and appendage during acute stroke imaging, this study detected filling defects in 13% of patients. These patients had more severe strokes and higher mortality, suggesting therapeutic implications for early detection.","created":"2026-07-03T10:25:03Z","updated":"2026-07-03T13:24:30Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Door het scanbereik van CT-angiografie bij acute CVA's uit te breiden naar het linker atrium en hartoor werden bij 13% van 299 patiënten vuldefecten gevonden. Deze patiënten hadden ernstigere beroertes, hogere sterfte en vaker bekende atriumfibrilleren. Vroege detectie kan therapeutische consequenties hebben.","abstract_original":"BACKGROUND: The left atrium (LA) and left atrial appendage (LAA) are common sites of thrombus formation leading to cardioembolic stroke. We aimed to include LA/LAA in acute-phase stroke CT angiography (CTA) to detect potential embolic sources early. METHODS: The CTA scan range was extended to include the LA/LAA. We retrospectively reviewed CTAs from patients treated at Donostia University Hospital between December 2020 and November 2021. LA/LAA images were classified as normal filling, non-well-defined filling defect, and thrombus-suggestive filling defect. Clinical, demographic, and stroke severity data were compared across groups. RESULTS: Among 299 patients included, 6 (2%) had thrombus-suggestive filling defects, and 32 (11%) had non-well-defined defects. Both groups had more severe strokes (median NIHSS 16 vs. 13, p < 0.01), higher mortality (29% vs. 6%, p < 0.01), and more pre-existing heart disease (74% vs. 27%, p < 0.01) and known atrial fibrillation (AF) (63% vs. 8%, p < 0.01). AF was more frequently diagnosed during follow-up in the non-well-defined filling defect group than in the normal group (50% vs. 19%, p = 0.02). Prior AF was the only independent predictor of thrombus-suggestive filling defect, which was observed despite high rates of anticoagulation (50%). CONCLUSIONS: Including LA/LAA in acute CTA allows early identification of thrombus-suggestive and non-well-defined filling defects, both linked to worse outcomes and potential therapeutic consequences."}