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Embolic Stroke Caused by Aortic Ruptured Plaque and Thrombus Visualized by Angioscopy
Yoshiharu Higuchi1, Atsushi Hirayama1, Sei Komatsu2
1Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
JACC. Case Reports
|July 28, 2021
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.
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.
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