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Complex atheromatous plaques in the descending aorta and the risk of stroke: a systematic review and meta-analysis

Aristeidis H Katsanos1, Sotirios Giannopoulos1, Maria Kosmidou1

  • 1From the Department of Neurology (A.H.K., S.G., A.P.K.) and First Division of Internal Medicine (M.K.), School of Medicine, University of Ioannina, Ioannina, Greece; Second Department of Neurology (K.V., G.T.) and Second Department of Cardiology (J.T.P.), Attikon Hospital, School of Medicine, University of Athens, Athens, Greece; and International Clinical Research Center, Department of Neurology, St Anne's University Hospital in Brno, Brno, Czech Republic (G.T.).

Stroke
|May 3, 2014
PubMed

Insights

Complex plaques in the descending aorta are more common in stroke patients, suggesting generalized atherosclerosis. However, this study found no direct causal link between descending aorta atherosclerosis and cerebral embolism.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Vascular Surgery

Background:

  • Aortic arch plaques are known stroke causes.
  • Descending thoracic aorta plaques are a potential, less-understood embolic source.
  • Retrograde aortic flow may link descending aorta plaques to cryptogenic cerebral infarction.

Purpose of the Study:

  • To investigate the association between descending aorta atheromatosis and cerebral ischemia.
  • To evaluate descending aorta plaques as a potential embolic source for stroke.

Main Methods:

  • Systematic review and meta-analysis of prospective observational studies.
  • Included studies reported descending aorta plaque prevalence in stroke patients and unselected populations.
  • Transesophageal echocardiography was the primary examination method.

Main Results:

  • 11 studies with 4000 patients (667 stroke, 3333 unselected) were analyzed.
  • Complex descending aorta plaques were significantly more prevalent in stroke patients (25.4%) than unselected individuals (6.1%).
  • No significant difference in plaque prevalence was found between cryptogenic and unclassified cerebral infarction groups.

Conclusions:

  • Complex descending aorta plaques may indicate generalized atherosclerosis and high vascular risk.
  • The study did not find direct evidence supporting descending aorta atherosclerosis as a cause of cerebral embolism.
  • Further research may be needed to clarify the role of descending aorta plaques in stroke etiology.
Abstract

Keywords:
aorta, thoracicatherosclerosisbrain ischemiastroke

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