Article Text

Download PDFPDF
Transoesophageal echocardiography: which stroke patients benefit most from this investigation?
  1. C Stöllberger1,
  2. J Finsterer2
  1. 1Krankenanstalt Rudolfstiftung, 2 Medizinische Abteilung, Juchgasse 25, A-1030 Vienna, Austria; claudia.stoellberger@chello.at
  2. 2Neurologisches Krankenhaus, Riedelgasse 15, Vienna

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

In a recent article in this journal, Strandberg et al reported 441 patients who were investigated by transoesophageal echocardiography (TOE) after ischaemic stroke or transient ischaemic attacks.1 The authors looked for cardiac sources of embolism. They found that in patients who were in sinus rhythm and without any cardiac disease, 8% have been given anticoagulation drugs on the basis of TOE data.

Although we agree with their conclusions that TOE should be used in patients with stroke we have, however, concerns about the following points:

  • No definition is given of what is meant by “anticoagulation drugs.” Did the authors mean only oral anticoagulation with acenocoumarol or phenprocoumon, or did they also mean other antithrombotic drugs like heparin, acetylsalicylic acid, or clopidogrel?

  • What contraindications to anticoagulant drugs did they consider?

  • How long after the stroke or transient ischaemic attack was anticoagulant treatment started?

  • The decision about anticoagulation was based on “clinical assessment.” They report that “if a minor risk factor for a cardiac source of embolism was detected, anticoagulation treatment was started after clinical consideration of the …

View Full Text