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An update on aortic causes of ischemic stroke
O Heinzlef1, A Cohen, P Amarenco
1Department of Neurology, Saint-Antoine Hospital, Paris, France.
Current Opinion in Neurology
|February 1, 1997
Summary
Atherosclerotic disease of the aortic arch is an underestimated cause of stroke, especially in older adults. Transesophageal echocardiography can effectively examine this condition, guiding future stroke prevention trials.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Surgery
Background:
- Atherosclerotic disease of the aortic arch is an emerging cause of embolic events, particularly moving thrombi.
- It is recognized as an independent risk factor for ischemic stroke and recurrent vascular events.
Purpose of the Study:
- To highlight the significance of aortic arch atherosclerosis as a source of stroke.
- To emphasize the utility of transesophageal echocardiography in evaluating this condition.
- To underscore the implications for patient management and clinical trial design.
Main Methods:
- Review of pathological and transesophageal echocardiographic studies.
- Analysis of atherosclerotic disease prevalence in different age groups.
- Assessment of transesophageal echocardiography's safety and tolerability in elderly patients.
Main Results:
- Aortic arch atherosclerosis is a frequent cause of cryptogenic stroke in patients over 60, particularly in their eighties.
- Transesophageal echocardiography is a safe and effective tool for examining the aortic arch, even in the elderly.
- This condition is a strong predictor of recurrent vascular events.
Conclusions:
- Aortic arch atherosclerosis is an underdiagnosed source of stroke and systemic emboli.
- Transesophageal echocardiography is crucial for identifying this risk factor.
- Randomized trials are needed to evaluate therapeutic strategies for patients with aortic arch atherosclerosis to reduce recurrent vascular events.