Two cases of protruding atherosclerotic plaque with mobile projections in the aortic arch

We recently studied two patients with cerebral embolism, in whom transesophageal echocardiography revealed protruding atherosclerotic plaques with freely mobile projections in the aortic arch. Ultrasonic imaging showed that the carotid artery was normal, and transthoracic and transesophageal echocardiography did not reveal a cardiac embolic source in either case. In one patient, we observed that an atherosclerotic plaque became ulcerated and developed mobile projections over the course of a year. More consideration should be given to the thoracic aorta as a source of embolism in patients with unexplained stroke.