[Aortic atheroma and splenic emboli]

The association between atheroma of the thoracic aorta and systemic embolization to the brain and other organs was discovered in the early 1990s in concordance with the improvement in the trans-esophageal echocardiography technique. The optimal treatment for secondary prevention of recurrent emboli is controversial, since the results of several studies differ and even contradict one another. In this article, the authors describe a man with splenic infarct, originating from a mobile descending aortic plaque. The cLinical approach for prevention of recurrent emboli is discussed, including the surgical and medical treatment options, and the literature on that subject is reviewed. Due to the absence of guidelines for optimal treatment in these cases and the Lack of conclusive randomized trials, the chosen treatment should be individualized, based on the characteristics of the plaque and other risk factors of each patient.