[HT-09] ホットトピックス09
Is the concept of embolic stroke of undertermined source (ESUS) dead or alive?

[HT-09-2] 潜因性脳梗塞における動脈原性塞栓源の検索

^○上野 祐司¹, 卜部 貴夫², 服部 信孝¹ (1.順天堂大学医学部附属順天堂医院, 2.順天堂大学医学部附属浦安病院)

Two clinical trials to compare direct oral anticoagulants (DOACs) and aspirin did not show superiority of DOACs over aspirin in patients with embolic stroke of undertermined source (ESUS). It is argued on the reasons for the negative results that covert atrial fibrilltion may not be a major cause and arteriogenic embolism may be prevalent than ever thought. In this symposium, we analyze the factors affecting the results, reconsider the the currrent concept of EUS, and perspect future direction of antithrombotic therapy.

Yuji Ueno, MD. PhD, is Associate Professor, Department of Neurology, Juntendo University Faculty of Medicine. He is also a neurosonologist especially in transesophageal echocardiography, and he has experienced more than 1500 cases. His clinical interesting is the investigation of the pathological mechanisms of ischemic stroke. His research efforts have focused on several fields including 'Investigation of potential embolic sources in ESUS', 'Surrogate markers for aortogenic brain embolism', 'Impact of omega-3 polyunsaturated fatty acids in stroke', and 'Lipid management for secondary prevention of stroke'. Notably, he recently carried out a a multicenter registry of cryptogenic stroke patients who underwent transesophageal echocardiography (CHALLENGE ESUS/CS) in Japan, which elucidated the pathophysiology of cryptogenic stroke.
In 2015, He received a Kusano award from Japanese Stroke Society-Japan Heart Association.