[Determinants of arterial embolism with special reference to atheromatous changes of the thoracic aorta]

Potential sources of arterial embolism were evaluated with special emphasis on aortic atheromatosis in patients who underwent transesophageal echocardiography for various clinical reasons. Among 375 patients, 166 had suffered from cerebrovascular disease or peripheral embolism and 209 were free from symptoms of embolism. Univariate analysis revealed that atheromatosis of the aortic arch and descending aorta as well as cardiac thrombi, aneurysms of the interatrial septum and arterial hypertension were significantly more common in patients who had a history of embolism or ischemic stroke. In a stepwise multiple regression analysis, aortic arch atheromatosis (odds ratio 1.7, 95% CI 1.1-2.6), cardiac thrombi (odds ratio 4.1, 95% CI 1.7-9.8), atrial septal aneurysm (odds ratio 3.0, 95% CI 1.2-7.8) and arterial hypertension (odds ratio 1.8, 95% CI 1.1-3.0) were determined as independent predictors of embolic symptoms. We conclude that atheromatous lesions of the aortic arch are an independent risk factor for arterial embolism and ischemic stroke among other well known sources of embolism.