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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Embolic Stroke Caused by Aortic Ruptured Plaque and Thrombus Visualized by Angioscopy.

Yoshiharu Higuchi1, Atsushi Hirayama1, Sei Komatsu2

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JACC. Case Reports
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Summary

Aortogenic embolization, a cause of cryptogenic stroke, involves thrombi and ruptured plaques in the aorta releasing embolic materials. Angioscopy visualized these dynamic events, offering insights into stroke mechanisms.

Keywords:
angioscopyembolic strokeruptured plaquesthrombus

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Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Vascular Surgery

Background:

  • Cryptogenic stroke poses a diagnostic challenge.
  • Aortogenic embolization is a significant, yet often under-recognized, cause of stroke.
  • Understanding aortic sources of embolism is crucial for stroke prevention.

Purpose of the Study:

  • To investigate the role of aortogenic embolization in cryptogenic stroke.
  • To visualize and characterize embolic sources within the aorta.
  • To elucidate the dynamic processes leading to emboli release from the aortic wall.

Main Methods:

  • Utilized angioscopic surveillance of the aortic wall.
  • Directly visualized intraluminal structures and plaque morphology.
  • Observed dynamic events of thrombus and plaque rupture.

Main Results:

  • Angioscopy clearly identified thrombi on the aortic wall.
  • Spontaneously ruptured plaques were visualized.
  • These lesions were observed to dynamically liberate embolic materials into circulation.

Conclusions:

  • Aortogenic embolization is a direct mechanism contributing to cryptogenic stroke.
  • Angioscopy provides direct visualization of embolic sources within the aorta.
  • These findings highlight the importance of aortic assessment in cryptogenic stroke evaluation.