Related Experiment Video
Updated: Sep 23, 2025

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
The Relationship Between Aortic Arch Calcification and Recurrent Stroke in Patients With Embolic Stroke of
Xiaofeng Cai1, Yu Geng1, Sheng Zhang1
1Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China.
Background:
Aortic arch calcification (AoAC) is associated with plaque development and cardiovascular events. We aimed to estimate the predictive value of AoAC for stroke recurrence in patients with embolic stroke of undetermined source (ESUS).
Methods:
Consecutive patients with ESUS who were admitted to our center between October 2019 and October 2020 and who had a 1-year follow-up of stroke recurrence were retrospectively reviewed. According to our AoAC grading scale (AGS), AoAC was classified into four grades based on chest computed tomography (CT) findings: no visible calcification (grade 0), spotty calcification (grade 1), lamellar calcification (grade 2), and circular calcification (grade 3).
Results:
Of the 158 patients with ESUS (age, 62.1 ± 14.5 years; 120 men) enrolled, 24 (15.2%) had recurrent stroke within a 1-year follow-up. The Cox regression analysis showed that stroke history [hazard ratio (HR), 4.625; 95% confidence interval (CI), 1.828-11.700, p = 0.001] and AoAC (HR, 2.672; 95% CI, 1.129-6.319; p = 0.025) predicted recurrent stroke. AGS grade 1 was associated with a significantly higher risk of stroke recurrence than AGS grade 0 (HR, 5.033; 95% CI, 1.858-13.635, p = 0.001) and AGS grade 2 plus 3 (HR, 3.388; 95% CI, 1.124-10.206, p = 0.030). In patients with AoAC, receiver operating characteristic (ROC) analysis showed that AGS had a good value in predicting stroke recurrence in patients with ESUS, with an area under curve (AUC) of 0.735 (95% CI = 0.601-0.869, p = 0.005).
Conclusions:
Aortic arch calcification, especially spotty calcification, had a good predictive value for stroke recurrence in patients with ESUS.
Related Concept Videos
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
Aneurysm I: Introduction

