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Aortic atheromas: current concepts and controversies-a review of the literature

Thenappan Thenappan1, Jaffar Ali Raza, Assad Movahed

  • 1Section of Cardiology, Department of Medicine, The Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.

Echocardiography (Mount Kisco, N.Y.)
|February 14, 2008
PubMed

Insights

Transesophageal echocardiogram (TEE) identifies aortic atheromas, linked to stroke in high-risk patients. Treatment strategies for these plaques remain undefined, necessitating further research into anticoagulation and statins.

Area of Science:

  • Cardiovascular Imaging
  • Neurology
  • Vascular Medicine

Background:

  • Transesophageal echocardiogram (TEE) use has increased recognition of aortic atheromas.
  • Aortic atheromas are associated with stroke risk, particularly complex plaques, in high-risk populations.
  • Evidence suggests aortic atheromas indicate generalized atherosclerosis.

Purpose of the Study:

  • To review the current understanding of aortic atheromas identified by TEE.
  • To discuss the association between aortic atheromas and stroke.
  • To explore current and potential treatment strategies for aortic atheromas.

Main Methods:

  • Review of retrospective and prospective follow-up studies.
  • Analysis of TEE-based studies in varying risk populations.
  • Discussion of emerging noninvasive imaging modalities like MR and CT scans.

Main Results:

  • TEE is the preferred imaging modality for aortic atheromas.
  • Association with stroke is evident in high-risk groups but not low-risk cohorts.
  • Anticoagulation with warfarin shows mixed outcomes; statins show promise for plaque stabilization.

Conclusions:

  • Aortic atheromas are markers of systemic atherosclerosis.
  • Treatment for aortic atheromas is not well-defined.
  • Randomized controlled trials are needed to establish the efficacy of anticoagulation and statins.

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