Concomitant Pulmonary Embolism and Acute Ischemic Stroke Using Undergoing Extended Chest CT Angiography: A Cohort Study

We conducted a single-center prospective cohort study in Ontario, Canada, to assess concomitant pulmonary embolism (PE) in hyperacute stroke. Stroke CT angiography was modified to start at the diaphragm in order to include the chest. Primary outcome of PE was reported by cardiothoracic/chest radiologists. 12/208 stroke patients had an acute PE (5.8%), all of which were clinically asymptomatic, despite imaging in some showing right-heart strain. None had cancer and only half had a patent foramen ovale. Patients with PE tended to have more severe stroke, large vessel occlusion and worse outcomes. The implications and management of these findings require further exploration.