ArticleClinical neuroradiology2021
Feasibility of the Big 5-Jena eCS Protocol : First Experience Implementing a New Extended CT Protocol in the Initial Diagnostics of Ischemic Stroke.
Article in Clinical neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Frequency and management of non-cardiac incidental findings on cardiac CT in patients with a suspected stroke.European stroke journal · 2026Article
- Cardiac CT in Large Vessel Occlusion Stroke for the Evaluation of Non-Thrombotic and Non-Atrial-Fibrillation-Related Embolic Causes.Neurology international · 2025Article
- Long-Term Clinical Implications of High-Risk Cardiac Computed Tomography Findings in Patients With Acute Ischemic Stroke.Journal of the American Heart Association · 2024Article
- Cardiac thrombi detected by CT in patients with acute ischemic stroke: A substudy of Mind the Heart.European stroke journal · 2023Article
- Free-Breathing, Non-Gated Heart-To-Brain CTA in Acute Ischemic Stroke: A Feasibility Study on Dual-Source CT.Frontiers in neurology · 2022Article
- Extended Imaging Protocols to Elucidate Sources of Cardiovascular Embolism in the Work-up of Ischemic Stroke.Clinical neuroradiology · 2021Article
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe most common protocols in the initial diagnostic of acute ischemic stroke do not assess cardiogenic or aortic causes of embolism. These are usually evaluated later by transthoracic (TTE) or transesophageal (TEE) echocardiography. This study aimed to evaluate the feasibility of a diagnostic tool for thoracic cardiovascular thrombi according to the first experience with a new extended cardio-stroke protocol (Big 5-Jena eCS protocol) in acute stroke patients.
methodsRetrospective analyses of the tomography scans database of the Jena University Hospital were performed. We included a total of 67 patients in the feasibility analyses, based on the evaluation of three outcomes.
resultsPrimary outcome: the Big 5-Jena eCS protocol was able to detect thoracic cardiovascular thrombi in a total of 20 patients in different locations including the arch of the aorta, the aortic valve, the left atrium, the left atrial appendage, the left ventricle, and the pulmonary arteries. Secondary outcome: implementating the protocol did not result in a significant elevation of the radiation exposure compared to traditional protocols. Tertiary outcome: the new protocol identified seven cases that were considered negative by echocardiography.
conclusionThe implementation of an extended cardio-stroke protocol is feasible, no significantly time-consuming, acquiring assessable imaging, and maintaining radiation exposure acceptable. The Big 5-Jena eCS protocol was also able to detect some thrombi not reported by TTE or TEE; however, due to our data's explorative character, a conclusive comparison with cardiac ultrasound is not possible. A prospective pilot study and clinical trials should be conducted to assess the diagnostic accuracy of this protocol compared to echocardiography and determine the potential impact on diagnostic and treatment decisions.
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