Abstract Details

Title Feasibility of Using Cardiac CTA in Ischemic Stroke Workup - A Real-World Pilot Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-016

Objective To assess the feasibility of cardiac CT angiography (CCTA) in routine ischemic stroke workup.

Background Echocardiography, the current gold standard for evaluating cardioembolic sources of acute ischemic stroke (AIS), is relatively low-yield, not readily available at all hospitals, and may delay treatment and disposition. CCTA offers superior visualization of cardiac structures, but is not a standard practice. We report the preliminary results of a pilot study assessing the feasibility of integrating CCTA into routine AIS and transient ischemic attack (TIA) evaluation.

Design/Methods In 2024, we incorporated CCTA as a standard of care diagnostic evaluation in ischemic stroke workup. CCTA was either integrated with CT angiograms of the head/neck utilizing a single contrast bolus or performed as a standalone study. We report the demographics, stroke characteristics, type of CCTA obtained, image quality, time taken, contrast dose, and radiation exposure using descriptive statistics.

Results Our study population consisted of 88 patients with the final diagnosis of AIS (70) and TIA (18). The median (IQR) age was 70 (65-80) and NIH Stroke Scale was 2.5 (0-9). 48.9% were female. Standalone CCTA (70) was more common than integrated CCTA (18). 90% had good imaging quality. The addition of CCTA to a patients conventional CTA Head/Neck increased radiation exposure by an average of 4.56 mSv, increased scanning time by 1 minute 19 seconds, and did not have a marked impact on the amount of contrast administered 98 mL vs 96 mL.

Conclusions In our real-world pilot study, CCTA demonstrated feasibility and provided good quality images for routine AIS evaluation. This occurred at the cost of increased radiation and scanning time, but not contrast dose.

Authors/Disclosures
Marcus Milani PRESENTER	Mr. Milani has nothing to disclose.
Nitin Ramanujam Chakravarthula, MBBS (University of Minnesota)	Dr. Chakravarthula has nothing to disclose.
Megan Tessmer, RN	Mrs. Tessmer has nothing to disclose.
Abbey Staugaitis	Abbey Staugaitis has nothing to disclose.
Christopher Streib, MD (Department of Neurology)	Dr. Streib has nothing to disclose.

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