Aortic plaque as a potential cause for cerebral ischemia

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.