Pre-existing Cardiac Thrombus in Patient of Acute Ischemic Stroke with Large Vessel Occlusion (P6.249)

Objective: To investigate the incidence of pre-existing cardiac thrombus in patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Background: AIS caused by thrombotic or embolic occlusion of intracranial blood vessels comprises of 70–80% of all strokes. Of which, approximately 14–30% cases are caused by cardiac sources of embolism.1–3 The existence of cardiac thrombus in patients with LVO can be as low as 2.7%. 4 AIS due to cardiac thrombus has been associated with short and long-term recurrence which makes its identification, a crucial part of a post-stroke evaluation. Design/Methods: Electronic medical records of Los Robles Hospital and Medical Center (LRHMC) from the period of Jan 2016 – Jun 2017 were reviewed retrospectively. Patients presented with AIS, diagnosed with LVO on cerebral angiography and had an echocardiogram as part of stroke workup, were included in the data analysis. Results: A total of 643 patients were admitted with the diagnosis of AIS during the selected period. Out of which, 114 patients were diagnosed with LVO on cerebral angiography. Two patients did not have the echocardiogram as part of stroke workup and were excluded. The mean age of 112 patients (male: 50 {44.64%}, female: 62 {55.36%}) was 72.56 with range of 35–99. 29 patients had both transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) as part of the post-stroke workup. 110 patient underwent subsequent mechanical thrombectomy (MT). 4 (3.5%) patients were diagnosed with cardiac thrombus, out of which 3 patients had a thrombus in left atrial appendage (LAA) and one had a thrombus in the left ventricle. Conclusions: The overall incidence of cardiac thrombus is although low, as it was seen as 3.5% in our study, but it merits an echocardiogram to be part of post-stroke workup in patients with LVO to indicate the start of anticoagulation as early as possible. Disclosure: Dr. Suriya has nothing to disclose. Dr. Taqi has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Stryker Neurovascular. Dr. Taqi has received research support from Stryker Neurovascular. Dr. Adl has nothing to disclose. Dr. Quadri has nothing to disclose. Dr. Sodhi has nothing to disclose. Dr. Mortazavi has nothing to disclose.