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Aortic plaque as a potential cause for cerebral ischemia
Y Guo1, A Rosengart, R Mitasch
1Department of Neurosurgery, Shenzhen People's Hospital, Shenzhen.
Insights
Thoracic aortic plaque is common in patients with cerebral ischemia, potentially causing embolic events. Age, diabetes, and coronary artery disease are key risk factors for developing aortic plaque.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Diagnostic Imaging
Background:
- Cerebral ischemia can stem from various sources, including cardiac and carotid artery diseases.
- The role of thoracic aortic plaque as an embolic source in cerebral ischemia is not fully understood.
- Investigating aortic plaque is crucial for identifying unexplained embolic events.
Purpose of the Study:
- To determine the prevalence and clinical significance of thoracic aortic plaque in patients with cerebral ischemia.
- To assess the embolic potential of aortic plaque.
- To investigate the correlation between aortic plaque and co-existing carotid or heart disease.
Main Methods:
- Transesophageal echocardiography (TEE) was used to evaluate the aortic arch and heart for embolic sources.
- Duplex ultrasound assessed the carotid arteries.
- Aortic arch atherosclerotic lesions were graded: normal (0), mild (1), moderate (2), and protruding/mobile plaque (3).
Main Results:
- Atherosclerotic lesions in the aortic arch were found in 75% of patients with cerebral ischemia.
- Significant correlations were observed between aortic plaque and pathological findings in the heart and carotid arteries.
- Age, diabetes, and coronary artery disease (CAD) were significantly associated with the presence of aortic plaque.
Conclusions:
- Aortic atherosclerosis is prevalent in patients experiencing cerebral ischemia.
- Thoracic aortic plaque is a potential source of embolic events, contributing to both unexplained emboli and embolic strokes.
- Age, diabetes, and CAD are significant risk factors for developing aortic arch atherosclerotic lesions.
Abstract:
The purpose of this study was to determine the prevalence, clinical significance, and embolic potential of thoracic aortic plaque in patients with cerebral ischemia and to further study the correlation of aortic plaque with carotid or heart disease. We used transesophageal echography (TEE) to evaluate potential source of emboli in aortic arch and heart, and duplex in carotid artery. A atherosclerotic lesion of aortic arch was defined as normal (0), mild plaque (1), moderate plaque (2) and protruding plaque or mobile plaque (3). 75 of 100 patients were found to have atherosclerotic lesion in aortic arch. 16 of 75 patients over degree 2 exhibited no pathologic finding of heart or carotid and 4 of 16 patients were classified as degree 3. The pathologic findings of heart and carotid were significantly correlated with aortic plaque. Age, diabetes, CAD were also significantly correlated with aortic plaque. Aortic atherosclerosis was common in cerebral ischemia. Aortic plaque might be responsible for not only some unexplained embolic events, but also for some of the embolic stroke in patient who have carotid artery or heart disease. Age, diabetes, CAD might be important risk factors in the development of atherosclerotic lesion in the aortic arch.