# Uitgebreid CTA-bereik detecteert vroegtijdig thrombus in het linker atrium bij acute CVA

*geplaatst 2026-02-24 · Atriumfibrilleren · Journal of neurology · doi 10.1007/s00415-026-13692-6 · https://hartvaat.nl/2026/02/24/uitgebreid-cta-bereik-detecteert-vroegtijdig-thrombus-in-het-linker-atrium-bij-a/*

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.

## English: Extended CTA scan range for early detection of left atrial and left atrial appendage thrombus and other filling defects in acute ischemic stroke.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Journal of neurology, https://doi.org/10.1007/s00415-026-13692-6. Bijgewerkt 2026-07-03T13:24:30Z. 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.